Job Summary:
Director, Pharmacy – Market is responsible to participate in the Traditional Work Group and lead CareSource market-specific Pharmacy & Therapeutics (P&T) committee.
Essential Functions:
- Act as key pharmacy point of contact for market entities and participate in required committees, such as Drug Utilization Review (DUR) Board, market-specific P&T, and MCO pharmacy director meetings
- Work with corporate pharmacy team to ensure key vendors are meeting market-specific requirements
- Responsible for ensuring employees’ performance is in compliance with regulatory requirements
- In collaboration with corporate pharmacy operations team, monitor pharmacy operational statistics and turnaround times specific to assigned market to ensure they are within regulatory compliance
- In collaboration with corporate pharmacy leadership team, assist in development and execution of pharmacy programs in assigned market to meet clinical, operational, and financial goals, with a key focus on the development of processes to achieve operational excellence in all areas
- Drive collaborative resolutions to identified issues and identify appropriate subject matter experts to assist in resolution when needed
- Collaborate with internal departments on cross-functional projects
- Drive collaboration between state partners and internal stakeholders
- Represent assigned market and pharmacy on company-wide committees relating to operational, regulatory and financial oversight
- Contribute to determining “as is” and “to be” operational and staffing needs of the market’s pharmacy department to meet standards as required by market regulations
- In conjunction with the VP, AVP, Pharmacy and market leadership, manage budgets and forecast for strategic planning and key initiatives, balance current and future needs effectively
- Review and analyze reports to understand drug spend within assigned market; utilize findings from reports to assist in managing budget and identification of Medical Cost Ratio (MCR) savings initiatives within the structure of corporate pharmacy department
- Represent Market/RX in meetings/testimony as needed with local providers and Legislators/Stakeholders
- Perform any other job duties as requested
Education and Experience:
- Bachelor’s Degree in Pharmacy is required; Doctor of Pharmacy (PharmD) is strongly preferred
- Master’s Degree in Business Administration is preferred
- A minimum of five (5) combined years health plan, operations and/or clinical management experience is required
- A minimum of three (3) years of recent contracting, quality improvement or management experience in a healthcare environment, preferably managed care is required
- Pharmacy Benefit Management operational experience is preferred
Competencies, Knowledge and Skills:
- Microsoft Access, Word and Excel proficiency
- Strong operational leadership skills
- Strong needs analysis and planning skills
- Strong people management skills
- Strong budgeting and financial skills
- Strong external and internal communications
- Thorough knowledge of pharmaceutical care and pharmacy benefit management practices
- Strong customer service skills
- Strong project management skills
- Knowledge of retail pharmacy operations
- Knowledge of pharmaceutical industry, regulations and trends
- Ability to work independently and within a team environment
- Strong attention to detail, including work plan development and execution skills
- Knowledge of the healthcare field overall
- Negotiation skills/experience
- Strong communications skills (written and oral)
- Ability to critically think, make decisions and problem solve
- Strong computer skills and good analytical and mathematical skills
Licensure and Certification:
- Current, unrestricted Registered Pharmacist (RPh) licensure in state of practice is required (AR License required or expectation to achieve License)
- To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
- CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.
Working Conditions:
- General office environment; may be required to sit or stand for extended periods of time
Compensation Range:
$132,900.00 - $232,700.00
CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary
Organization Level Competencies
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.
