Pharmacy Program Manager
3 weeks ago
Curative is reimagining health insurance - with $0 out of pocket costs and by reducing barriers to people seeking
care. We believe in a clear, simple health plan that allows our members to get zero-cost in-network care anytime
they need it. We want to put healthcare back in the hands of the patient and clinicians, with a focus on
preventative care. Curative is rapidly growing and is raising the bar in what people expect from their health plan.
Curative is seeking a Pharmacy Program Manager to join our fast-growing team. This role works closely with the
Pharmacy Director and provides oversight of the HealthPlan operations and acts as the liaison between the PBM
and the HealthPlan. Key responsibilities include supporting formulary updates, preparation of P&T materials,
supporting pharmacy Benefit Design, and providing training and education to other departments. As Curative
continues to have rapid growth, our business needs can change as we grow together.
This is a REMOTE Position.
ESSENTIAL DUTIES AND RESPONSIBILITIES
● Supports and manage health plan operations and ensures PBM aligns with benefit design
● Provides monthly updates for formulary and support submissions to PBM
● Reviews and manages PA guidelines for support of P&T committee and pharmacy benefit design
● Collaborates with key stakeholders and other interdepartmental staff to communicate pharmacy
strategies and clinical programs or initiatives
● Supports the management and implementation of new employer groups
● Performs related audits, quality assurance checks and ETE (spell this out) testing where necessary
● Develops applicable desktop procedures
● Provides training and education materials to key departments such as Member Services and Account Management
● Performs analytics and reporting data for leadership
● Works closely with Marketing to develop appropriate member communications
● Reviews and resolves complaints made by members and providers regarding formulary or pharmacy services
● Develops and manages pharmacy FAQ
● Supports the Pharmacy and Therapeutics Committee quarterly preparation and Meetings
● Supports and manages other related health plan operations
● Evaluates opportunities for operational or process improvements
● Work adhering to US regulatory and Quality System requirements (21 CFR 820, etc).
● Performs other duties as assigned
● Work hours Monday - Friday
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The
requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable
accommodations may be made to enable individuals with disabilities to perform the essential functions:
Required
● 2 years of Managed Care or PBM experience
● Possesses strong analytical skills and detail oriented
● Ability to work independently with minimal supervision
● Ability to collaborate and communicate with team members and other internal departments
● Understanding of claims processing and claims edits
● Proficient with MS Office applications- Word, Power Point, Excel, and Access
● Intermediate to advanced pharmacy drug recognition
● Ability to work in a dynamic and fast-paced environment
Preferred Qualifications
● Current Project Management certification
EDUCATION and/or EXPERIENCE
● Bachelors degree (B. A.) from four-year college or university; or one to two years related experience
and/or training; or equivalent combination of education and experience.
CERTIFICATES, LICENSES, REGISTRATIONS
● Must possess an active Pharmacy Technician license in the applicable PTCB.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while
performing the essential functions of this job. Reasonable accommodations may be made to enable individuals
with disabilities to perform the essential functions.
●While performing the duties of this Job, the employee is regularly required to sit; use hands to handle or
feel; talk; and hear.
●For this position the percentage of expected Travel is: 15%-20% of the time
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