What are the responsibilities and job description for the Pharmacy Associate Director position at CenCal Health?
Central Coast Salary Range: $192,240 - $288,360
Job Summary
This position is responsible for:
1. Provide senior leadership level advice and guidance on pharmacy benefit administration, pharmacy relations, clinical consultation functions and actively participating in health plan committees, initiatives and regulatory compliance activities as related to Pharmacy Services.
2. Provide strategic and clinical leadership of Pharmacy Services Operations, including: oversight of daily operational, administrative and clinical programming of Pharmacy Services, and pharmacy-focused provider education initiatives; managing relationships with internal and external partners, inclusive of industry relations and evaluation of rebate opportunities; serving as the Pharmacy Services lead on program implementation of utilization management, population health and case management as relevant to pharmacy process(es) and data; and providing clinical views of prior authorization medical-pharmacy (PAD) benefit, as appropriate.
3. Collaborate to direct, manage and supervisor Pharmacy Services Department staff.
Duties & Responsibilities
Oversee the review and processing of the prior authorization request for coverage determinations.
Responsible for the pharmacist and technician workflow and ensures clinical appropriateness and regulatory compliance.
Responsible for ongoing guideline oversight and evaluation, and annual P&T criteria adoption.
Monitor and report monthly dashboard on trends and clinical and operational metrics.
Identify and lead opportunities to drive efficiency and effectiveness in processes and programs.
Lead the pharmacy team to ensure appropriate and timely access for members medication needs through the Medi-Cal RX program via the portal, clinical liaisons, and the administrator office hours.
Oversee the Pharmacy Service teams contributions within the provider notifications (i.e., bulletin, newsletters, and announcements) and provider educations initiatives.
Co-chairs the Pharmacy & Therapeutics Committee and is responsible for coordinating the packet content with the Director around therapeutic class review, operational metrics and regulatory reporting.
Directly supervises clinical pharmacists and is responsible for professional development, ensuring competency and overseeing Department deliverables.
Works in conjunction with and provides thought partnership to the Director of Pharmacy on adherence to department budgeting, fiscal/fiduciary oversight, and program strategy.
Serves as the primary lead individually, virtually or as represented by designee for external facing relationships, including industry relations, regulatory adherence, and vendor support.
Other duties as assigned.
Ability to motivate others to create extraordinary results, and unite people to turn challenges into successes by embracing The Five Practices of Exemplary Leadership of The Leadership Challenge:
1. Model the Way:
Clarify values by finding your voice and affirming shared values
Set the example by aligning actions with shared values
2. Inspire a Shared Vision
Envision the future by imagining exciting and ennobling possibilities
Enlist others in a common vision by appealing to shared aspirations
3. Challenge the Process
Search for opportunities by seizing the initiative and my looking outward for innovative ways to improve
Experiment and take risks by consistently generating small wins and learning from experience
4. Enable Others to Act
Foster collaboration by building trust and facilitating relationships
Strengthen others by increasing self-determination and developing competence
5. Encourage the Heart
Recognize contributions by showing appreciation for individual excellence
Celebrate the values and victories by creating a spirit of community
Knowledge/Skills/Abilities
Required:
Thorough knowledge of Medi-Cal and prepaid health programs;
Thorough knowledge of computerized drug programs;
Thorough knowledge of drug utilization;
Thorough knowledge of drugs and supplies required in the operation of a pharmacy;
Thorough knowledge of and proficiency with Windows-based PC systems and Microsoft Word, Excel, PowerPoint and other databases and computer programs;
Working knowledge of the principles and practices of supervision, training and performance management;
Ability to remain current on industry knowledge, trends, and best practices; and
Ability to interpret information and effectively communication to a wide variety of clinical and non-clinical audiences.
Knowledge of drug utilization, current medical practice standards and appropriate medication usage
Ability to work with multiple software computer programs in the development of pharmacy reports
Ability to communicate effectively, both orally and in writing
Ability to maintain accurate records
Preferred:
Experience in vendor oversight, procurement and contracting
Experience in rebate contracting and reconciliation
Education & Experience
Pharmacy Doctorate (Pharm. D.) or equivalent
Current unrestricted California Pharmacist license
Six (6) years of experience as a practicing Pharmacist in a hospital, pharmacy retail pharmacy or health plan which must have included experience with drug formularies, pharmacy benefit managers, and drug billings
Seven-Ten (7-10) years of experience supervising, managing and directing staff in a Pharmacy or healthcare setting
Seven-Ten (7-10) years Experience in a Managed Care setting
California license in good standing
Salary : $192,240 - $288,360