Under the direction of the VP of Pharmacy Program, the Clinical Pharmacy Director will be responsible for the coordination of all pharmacy programs with the Medical Management leaders to ensure appropriate medication use and cost effectiveness. This position will collaborate with the Regional Medical Director, market and care management leaders to improve QI metrics related to medication management; manages the coordination, implementation and communication of the Medication Assistance Program (MAP) for WellMed. Primary Responsibilities:Lead the planning and implementation of pharmacy programs and initiatives Manage and coach the direct reporting individuals in the Pharmacy Department Update and maintain pharmacy program policies and procedures to ensure compliance with CMS requirements Reads, analyzes, and interprets common scientific and technical journals, financial reports, and legal documents Responds to inquiries or complaints from customers or members of the business community and effectively presents information to top management and/or external constituents Communicate effectively with key customers (health plans etc.) to keep them informed of pharmacy programs and initiatives Communicates effectively with key external constituents as needed (clinics, physician group, hospital) regarding pharmacy program, preferred drug list and pharmacy processes Provides routine, timely and accurate communication to health plan management regarding pharmacy programs, cost issues, utilization issues, budget performance, etc. Supports health plan initiatives that include pharmacy components Serves as a clinical resource and consultant in all areas of pharmacy and medication management Develops and implements clinical cost of care strategies and quality initiatives as needed to help reduce pharmacy cost and utilization Supports medical management and clinical/quality initiatives across the organization Manages injectable drugs under Part B by developing medical necessity policies for key injectable drugs, management of the specialty pharmacy sourcing for injectable drugs Develops and implements clinical cost of care strategies for auditing of B vs. D claims in coordination and collaboration with claims and configuration Manages relationships with Physician Business Managers (PBMs) to ensure information is shared with providers for improvement of utilization and quality Participates in QI and other committee meetings as appropriate Travels for business up to 25% either in the TX market or to FL market Completes significant special projects and performs all other related duties as assigned
Required Qualifications:Doctor of Pharmacy degree Active, unrestricted pharmacy license in Texas 2+ years of supervisory/management experience 3+ years of experience with Medicare Part D programs required Ability to manage multiple complex, concurrent projects Excellent written and verbal communication and relationship building skills Planning and organizational skills to demonstrate leadership and initiative Strong interpersonal skills. Ability to work independently, as well as a member of a team Proficient with Microsoft Word, Excel, Outlook, PowerPoint Experience working with provider relations, working within various payor environments, and risk management Ability to travel up to 25% in the TX or FL marketPreferred Qualifications:Board certification by the Board of Pharmacy Specialties (BPS) Certified Geriatric PharmacistCareers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.SM Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.