Pharmacy Services Director

4 weeks ago

Davis, Oklahoma, United States Intermountain Health Full time

Job Summary:

The Pharmacy Services Manager provides strategic leadership and direction to SelectHealth Pharmacy Services and SelectHealth Prescriptions. This position contributes to the clinical and operational direction of the department, identifying and promoting changes to provide cost-effective quality pharmacy benefits to members.

Key Responsibilities:

  • Provides direct management to pharmacy clinical coordinators, multiple pharmacy residents, and the business development consultant.
  • Analyzes pharmacy claims to identify areas of utilization aberrations and opportunities for cost-efficiencies.
  • Manages the clinical administration of Pharmacy Services, including formulary, academic detailing/education, and the residency program.
  • Oversees the Pharmacy & Therapeutics (P&T) Newsletter and other communications to providers and pharmacies.
  • Ensures coordination and communication of pharmacy benefit management (PBM) programs, including drug manufacturer contracting, P&T Committee activities, physician communication/education, retail/community pharmacy, NCQA qualification, information services, clinical intervention programs, drug usage evaluation programs, and pharmacy outcomes research.
  • Maintains positive partnerships and relations with contracted retail pharmacies and pharmaceutical companies.
  • Coordinates, manages, and monitors pharmacy claims processing services, utilization management, and prior authorization protocols.
  • Participates in, and works with, corporate drug manufacturers to obtain rebates, price discounts, and disease management plans, or other cost reductions.
  • Aids in contracting and auditing the SelectHealth Pharmacy Network.
  • Coordinates clinical pharmacy programs with the different Intermountain Clinical Programs.
  • Conducts Drug Utilization Review projects as appropriate, which includes the ability to query and analyze pharmacy data.
  • Coordinates and oversees Pharmacy Resident Program and student rotations.
  • Coordinates the appropriate use of specialty medications, including contractual arrangements and claims adjudication.
  • Promotes stand-alone PBM through relationships with brokers and key employer group executives.
  • Supports the education and promotion of pharmacy services to both internal and external customers.
  • Responsible for the administration of all medication therapy management programs for Medicare Part D, Medicaid, Commercial lines of business, and medical homes.
  • Provides direct support and direction for the management of Medicaid pharmacy services and the Medicaid Restriction program to assure maximal cost-effective benefit administration.
  • Responsible for the creation and maintenance of the SelectHealth medication fee schedules, including the MAC list for pricing of generic drugs, J-code fee schedules for use in physician offices, retail pharmacies, specialty pharmacies, home health, and infusion centers.

Requirements:

  • Pharm D. degree or Masters degree from an accredited school of pharmacy.
  • State license to practice pharmacy and dispense controlled substances.
  • Five years of pharmacy practice experience in a managed care and hospital environment.
  • Five years of Pharmacy Benefits management experience.

Preferred Qualifications:

  • Advanced degree in business management or healthcare administration.
  • Pharmacy experience in a managed care setting, including an ASHP accredited managed care residency.
  • Strong health care systems orientation, including managed care, retail, and hospital pharmacy, pharmacy contracting, pharmaceutical company contracting.
  • Strong verbal and written communication skills.
  • Personal computer skills, including word processing and spreadsheets.

Physical Requirements:

SH only

Interact with others requiring employee to verbally communicate as well as hear and understand spoken information.

Operate computers, telephones, office equipment, and manipulate paper requiring the ability to move fingers and hands.

See and read computer monitors and documents.

Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.

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