What are the responsibilities and job description for the SPECIALITY PHARMACY PROGRAM ADMINISTARTOR position at Covenant HealthCare?
Overview: The Specialty Pharmacy Program Administrator is responsible for overseeing the day-to-day operations of the specialty pharmacy program, ensuring the delivery of high-quality, patient-centered care. This role involves managing all operational aspects of the program, including patient access services, medication distribution, and regulatory compliance, while also leading the development and continuous improvement of pharmacy services. The Specialty Pharmacy Program Administrator will collaborate with cross-functional teams to drive patient outcomes, optimize workflows, and enhance operational efficiency within the specialty pharmacy setting. Responsibilities: List the major areas of responsibilities (but are not comprehensive):
Program Operations Management
o Manage the day-to-day activities of the specialty pharmacy program, ensuring that operations run smoothly and efficiently, including medication dispensing, patient counseling, and delivery coordination.
o Oversee patient intake processes, including medication authorization, benefits verification, and insurance verification. Ensure that patients receive timely access to specialty medications and are supported throughout the entire therapy journey.
o Collaborate with purchasing technician to ensure accurate inventory management of specialty medications, including ordering, stocking, and tracking controlled substances and high-cost therapies. Monitor medication supply levels to prevent shortages or delays.
o Ensure the program adheres to all federal, state, and local regulations, as well as accreditation requirements (e.g., URAC, ACHC).
o Implement and monitor quality control standards for all pharmacy processes, including dispensing accuracy, medication counseling, and patient satisfaction. Address issues as needed to improve service delivery.
Program Development and Improvement
o Lead the development and expansion of specialty pharmacy services, including identifying new therapeutic areas, medications, and patient populations to target for services.
o Continuously assess and improve operational workflows to streamline processes, reduce errors, and enhance patient care.
o Lead initiatives aimed at improving medication adherence, reducing hospital readmissions, and optimizing patient outcomes.
o Utilize data analytics to track program performance, including medication adherence rates, patient satisfaction, and clinical outcomes.
o Provide regular reports to leadership on program progress, identifying areas for improvement or opportunities for growth.
o Develop and implement educational materials and outreach programs to support patients in managing their conditions and adhering to their medication regimens.
o Ensure patients have access to resources on disease management, side effects, and insurance support.
o Work closely with physicians, insurance companies, healthcare providers, and manufacturers to ensure seamless care coordination for patients.
o Foster strong relationships with external stakeholders to improve patient access to therapies and services.
Team Leadership and Staff Development
o Lead, supervise, and mentor a team of pharmacy technicians, patient care coordinators, and other specialty pharmacy staff. Ensure that staff are adequately trained on pharmacy systems, patient care protocols, and regulatory requirements.
o Develop and implement training programs for new hires and ongoing staff education to ensure the team stays up to date on the latest medications, industry practices, and compliance standards.
o Establish performance metrics for the specialty pharmacy team, monitor individual and team performance, and provide feedback and coaching as necessary. Conduct performance evaluations and support career development.
Financial Management and Budgeting
o Assist in the development and management of the specialty pharmacy program budget.
o Monitor expenses and revenue streams, ensuring that the program operates within budget while maintaining high-quality services.
o Ensure accurate billing and reimbursement processes, working with insurance providers and third-party administrators to resolve any issues with claims.
o Continuously assess cost-efficiency in the procurement and distribution of specialty medications, as well as other operational costs. Look for opportunities to negotiate pricing or optimize inventory management to reduce overall program costs.
Technology Integration and Innovation
o Oversee the implementation and use of pharmacy management software, patient management systems, and inventory tracking tools.
o Explore opportunities for telepharmacy services, remote patient monitoring, and digital health tools to enhance patient engagement, access to care, and adherence to prescribed therapies.
o Stay informed about industry trends, new technologies, and innovative care models.
o Lead initiatives to integrate new technologies or enhance existing systems to improve operational workflows and patient care.
Other duties as assigned Qualifications: EDUCATION/EXPERIENCE REQUIREMENTS
Preferred Doctor of Pharmacy (Pharm.D.) degree
Minimum 3 years experience in specialty pharmacy
Demonstrated human relation, effective communication, and computer literacy skills
Current and unrestricted licensure to dispense controlled substances in the State of Michigan
Current and unrestricted Pharmacy license in the State of Michigan
KNOWLEDGE/SKILLS/ABILITIES
Computer competency, including EPIC, MS Office, Outlook.
Superior knowledge of medication therapeutics
Clinical expertise in Pharmacy systems
Excellent verbal and written skills
Must be able to work well with the internal staff and public and able to be tactful in often hectic and stressful situations.
Sound judgment in handling confidential or sensitive issues and material.
Ability to develop and lead teams
WORKING CONDITIONS/PHYSICAL DEMANDS
This position is primarily based in ambulatory care clinics with direct reports located throughout the health system. Occasional travel to affiliated sites and some evening or weekend work may be required to meet patient and program needs.
Program Operations Management
o Manage the day-to-day activities of the specialty pharmacy program, ensuring that operations run smoothly and efficiently, including medication dispensing, patient counseling, and delivery coordination.
o Oversee patient intake processes, including medication authorization, benefits verification, and insurance verification. Ensure that patients receive timely access to specialty medications and are supported throughout the entire therapy journey.
o Collaborate with purchasing technician to ensure accurate inventory management of specialty medications, including ordering, stocking, and tracking controlled substances and high-cost therapies. Monitor medication supply levels to prevent shortages or delays.
o Ensure the program adheres to all federal, state, and local regulations, as well as accreditation requirements (e.g., URAC, ACHC).
o Implement and monitor quality control standards for all pharmacy processes, including dispensing accuracy, medication counseling, and patient satisfaction. Address issues as needed to improve service delivery.
Program Development and Improvement
o Lead the development and expansion of specialty pharmacy services, including identifying new therapeutic areas, medications, and patient populations to target for services.
o Continuously assess and improve operational workflows to streamline processes, reduce errors, and enhance patient care.
o Lead initiatives aimed at improving medication adherence, reducing hospital readmissions, and optimizing patient outcomes.
o Utilize data analytics to track program performance, including medication adherence rates, patient satisfaction, and clinical outcomes.
o Provide regular reports to leadership on program progress, identifying areas for improvement or opportunities for growth.
o Develop and implement educational materials and outreach programs to support patients in managing their conditions and adhering to their medication regimens.
o Ensure patients have access to resources on disease management, side effects, and insurance support.
o Work closely with physicians, insurance companies, healthcare providers, and manufacturers to ensure seamless care coordination for patients.
o Foster strong relationships with external stakeholders to improve patient access to therapies and services.
Team Leadership and Staff Development
o Lead, supervise, and mentor a team of pharmacy technicians, patient care coordinators, and other specialty pharmacy staff. Ensure that staff are adequately trained on pharmacy systems, patient care protocols, and regulatory requirements.
o Develop and implement training programs for new hires and ongoing staff education to ensure the team stays up to date on the latest medications, industry practices, and compliance standards.
o Establish performance metrics for the specialty pharmacy team, monitor individual and team performance, and provide feedback and coaching as necessary. Conduct performance evaluations and support career development.
Financial Management and Budgeting
o Assist in the development and management of the specialty pharmacy program budget.
o Monitor expenses and revenue streams, ensuring that the program operates within budget while maintaining high-quality services.
o Ensure accurate billing and reimbursement processes, working with insurance providers and third-party administrators to resolve any issues with claims.
o Continuously assess cost-efficiency in the procurement and distribution of specialty medications, as well as other operational costs. Look for opportunities to negotiate pricing or optimize inventory management to reduce overall program costs.
Technology Integration and Innovation
o Oversee the implementation and use of pharmacy management software, patient management systems, and inventory tracking tools.
o Explore opportunities for telepharmacy services, remote patient monitoring, and digital health tools to enhance patient engagement, access to care, and adherence to prescribed therapies.
o Stay informed about industry trends, new technologies, and innovative care models.
o Lead initiatives to integrate new technologies or enhance existing systems to improve operational workflows and patient care.
Other duties as assigned Qualifications: EDUCATION/EXPERIENCE REQUIREMENTS
Preferred Doctor of Pharmacy (Pharm.D.) degree
Minimum 3 years experience in specialty pharmacy
Demonstrated human relation, effective communication, and computer literacy skills
Current and unrestricted licensure to dispense controlled substances in the State of Michigan
Current and unrestricted Pharmacy license in the State of Michigan
KNOWLEDGE/SKILLS/ABILITIES
Computer competency, including EPIC, MS Office, Outlook.
Superior knowledge of medication therapeutics
Clinical expertise in Pharmacy systems
Excellent verbal and written skills
Must be able to work well with the internal staff and public and able to be tactful in often hectic and stressful situations.
Sound judgment in handling confidential or sensitive issues and material.
Ability to develop and lead teams
WORKING CONDITIONS/PHYSICAL DEMANDS
This position is primarily based in ambulatory care clinics with direct reports located throughout the health system. Occasional travel to affiliated sites and some evening or weekend work may be required to meet patient and program needs.
