Manager, Clinical Pharmacy Operations

This is a fully remote position, open to applicants in California.

📋 Description

• Develop, implement, and manage clinical pharmacy tools and programs that support corporate and regional drug utilization and financial objectives.

• Direct and oversee clinical pharmacy operations through subordinate personnel.

• Improve the quality of pharmaceutical care while promoting cost-effective utilization for members.

• Create, implement, and sustain clinical quality assurance, formulary management, drug utilization review, compliance, and educational programs.

• Coordinate clinical initiatives with other departments to ensure the implementation of integrated programs.

• Monitor staff quality assurance and confirm compliance with regulatory standards, including Medicare Star ratings and HEDIS measures.

• Supervise and/or devise clinical recommendations and guidelines for approval by the Pharmacy and Therapeutics committee.

• Keep abreast of clinical advancements and changes in evidence-based pharmacy practices.

• Ensure compliant administration of the pharmacy benefit.

• Act as the clinical pharmacy liaison to external agencies and healthcare providers.

• Serve as the primary contact for clinical pharmacy matters in the designated area.

• Execute additional duties as assigned.

• Adhere to all policies and standards.

⛳️ Requirements

• Doctor of Pharmacy degree from an accredited institution.

• One to three years of clinical pharmacy experience, including formulary development, drug utilization review, and/or medication therapy management.

• Four years of progressively responsible roles within managed care pharmacy.

• At least two years in a managerial position.

• Experience in public speaking.

• Must possess and maintain a current, valid, and unrestricted state Registered Pharmacist License for the assigned region(s).

• Proficiency in managed care or PBM clinical pharmacy operations, including clinical edits, drug utilization review, prior authorization, claims adjudication, or formulary management.

• Experience with Medicaid requirements, pharmacy claims standards, PBM partners, and cross-functional teams is strongly preferred.

• Experience in leadership and managing people.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase options.

• Tuition reimbursement program.

• Paid time off along with holidays.

• Flexible work arrangements including remote, hybrid, field, or office schedules.

• Additional forms of incentives may be included in total compensation.

• An equal opportunity employer dedicated to promoting diversity.