Manager, Clinical Pharmacy

The Manager, Clinical Pharmacy is a member of the pharmacy leadership team. The incumbent has responsibility and accountability for overseeing the pharmacy clinical strategy for all business segments including IFB, Commercial, Medicaid and Medicare. Key accountabilities include, but are not limited to, leading pharmacy formulary development and utilization management for all segments, new drug clinical assessment and management strategy; and oversight for both internal and delegated clinical services. This position works closely with the Manager, Pharmacy Operations to ensure cohesion between strategic, clinical, and operational strategies within Pharmacy Services to deliver efficient, effective, and high-quality clinical pharmacy services to our customers. Additionally, the Manager, Clinical Pharmacy is responsible for the deployment and development of a designated team of clinical pharmacists.

Key Accountabilities

Clinical Pharmacy Services Oversight

• Provides oversight and support for all clinical aspects of the pharmacy benefit, including elements such as drug formularies, clinical services, and utilization management.
• Develops and implements clinical strategies to manage drug costs and improve member outcomes consistent across all segments and markets
• Leads the annual clinical assessment of all drug categories to determine clinical formulary position and UM strategy aligned with clinical and financial objectives
• Prepares and presents clinical drug reviews at Medica's formal approval committee
• Reviews and analyzes drug utilization data to ensure optimal usage of medications
• Ensures access to cost-effective drugs for our customers
• Develops and implements clinical policies and procedures
• Ensures compliance with regulatory standards across all segments and markets
• Ensures the efficient and effective delivery of clinical pharmacy services for customers
• Represents clinical pharmacy services and actively participates in both internal and external cross-functional meetings
• Maintains up-to-date knowledge of new drugs, therapeutic trends, and healthcare laws and regulations
• Maintains accurate and current records of all formulary decisions and changes
• Addresses inquiries and disputes related to formulary decisions

Pharmacy Leadership

• Independently oversees day-to-day processes associated with maintaining clinical pharmacy services. Facilitates identification and resolution of barriers so that internal and vendor-delegated programs are implemented and functioning in a high quality, timely, and compliant manner
• Provides leadership, development, guidance, recognition and oversight of direct reports
• Serves as a mentor to staff with a set of goals and objectives that are clear and results-oriented
• Hires, develops, trains and retains high quality staff
• Fosters a collaborative, value-driven team culture of high standards and strong productivity
• Develops and maintains positive relationships with Medica leaders, key vendors, and colleagues within the pharmaceutical industry
• Behaves and leads in a manner that is consistent with Medica's mission, vision, and values

Additional Responsibilities

• Completes projects as assigned
• Actively participates in internal and external pharmacy meetings

Qualifications

• 5 years of progressive leadership experience in managed care or PBM
• Bachelor's degree in Pharmacy or PharmD required

• Previous health plan or PBM experience is required

• Previous experience managing a team of pharmacists is required

• Prior experience with pharmacy formulary development and utilization management required

Skills and Abilities

• Organized and can simultaneously execute through multiple projects and priorities
• Proven track record on consistently achieving desired results
• Self-starter, possessing willingness and ambition to work through ambiguity
• Creative thinker
• Excellent analytical and decision-making skills
• Motivated to problem solve
• Ability to present to an executive audience
• Collaborative, team-oriented spirit
• Excellent written and verbal communication skills
• Customer/patient focused

This position is a Remote role and will work remotely 100% of the time. To be eligible for consideration, candidates must have a primary home address located within any state where Medica is registered as an employer - AR, AZ, FL, GA, IA, IL, KS, KY, MD, ME, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WI.

The full salary range for this position is $108,400 - $185,900. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

Medica's commitment to diversity, equity and inclusion (DEI) includes unifying our workforce through learning and development, recruitment and retention. We consistently communicate the importance of DEI, celebrate achievements, and seek out community partnerships and diverse suppliers that are representative of everyone in our community. We are developing sustainable programs and investing time, talent and resources to ensure that we are living our values. We are an Equal Opportunity/Affirmative Action employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.