What are the responsibilities and job description for the Director, Clinical Pharmacy Services position at Centene Management Company LLC?
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
Candidates MUST reside in Indiana.
Position Purpose: Oversee the clinical pharmacy services function and develop new quality improvement and revenue enhancement activities
- Engage with pharmacy leaders and health plan leaders to support clinical program implementation, evaluation and expansion based on trend management and total cost of care savings opportunities (e.g., 1:1 sessions/calls with CFO?CEO/COO/VP Rx etc.)
- Support and drive interdepartmental partnerships to advance clinical pharmacy strategy through clinical program development and innovation
- Act as thought leader to Pharmacy Strategy team members and health plan pharmacists
- Partner with data analytics, medical economics and related teams to build financial and business case for pharmacy initiatives
- Plan, direct and implement pharmacy related activities
- Assist with the development and implementation of key contracts and ensure that relevant performance standards are met by vendors
- Ensure successful implementation of prior authorization and drug utilization review program and plan specific management initiatives
- Evaluate and recommend to pharmacy related activities and program design
- Ensure that all disputes, grievances and complaints involving pharmacy program issues are addressed timely
- Participate in external accreditation initiatives and relevant boards, task forces, committees, meetings and other activities
- Establish the strategic vision, objectives and policies and procedures for the pharmacy program in support of the corporate strategic vision
- Support the development of organizational policies and procedures, including pharmacy service quality, pharmacy utilization management and achievement of company goals
- Performs other duties as assigned
- Complies with all policies and standards
Education/Experience: Bachelor’s degree or advanced degree (PharmD., M.S) in pharmacy. 7 years of mail order, retail, hospital, managed care pharmacy experience, or pharmacy residency program experience. Direct Supervisory of pharmacy staff experience.
License/Certification: Current state’s Pharmacist license
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Salary : $145,100 - $268,800
