Senior Manager, Pharmacy

This is a fully remote position, open to applicants in Alabama, +24 more states.

📋 Description

• Supervise utilization management operations and clinical review teams for a designated Commercial or Government line of business.

• Create and implement strategies to meet operational and quality objectives.

• Foster relationships with stakeholders, internal and external partners, and vendors.

• Encourage teamwork across departments to optimize efficiencies, identify best practices, and facilitate implementation.

• Represent team requirements in budget planning as well as divisional and enterprise roadmaps, including technology and digital initiatives.

• Act as a liaison between frontline staff, leadership, and cross-functional partners.

• Oversee both clinical and non-clinical operational elements of pharmacy utilization management services.

• Assist managers with prioritization, program oversight, and corrective measures.

• Track dependencies, performance, and vendor/PBM services; identify risks, eliminate obstacles, and escalate issues as necessary.

• Manage or assist with corporate and departmental projects that impact pharmacy utilization management operations and vendors.

• Govern utilization management programs and policies to meet trend targets, lower medical expenses, and ensure cost-efficient operations.

• Identify operational initiatives and process improvements to enhance competitive positioning.

• Ensure programs adhere to State, Federal, and accrediting-body regulations and implement corrective action plans as needed.

• Assess pharmacy industry trends, best practices, challenges, and strategic needs to suggest and drive interventions and programs.

• Engage in departmental strategic planning and objectives to enhance performance, revenue growth, and the experience of members and providers.

• Provide clinical consultation on medication therapy and suggest utilization management strategies for both traditional and specialty therapies.

• Represent the Pharmacy department in committees, C-suite presentations, speaking engagements, PBM meetings, and customer interactions.

⛳️ Requirements

• Bachelor's degree or higher in Pharmacy.

• 8+ years of relevant experience.

• Alternatively, 10+ years of experience in a related field may be accepted in lieu of a degree.

• A current pharmacy license is mandatory.

• NC licensure may be required for certain roles.

• Preferred experience in leading teams and supporting career/professional development.

• Experience in culture and engagement support and interventions is preferred.

• Resource and budget management experience is desirable.

• Project planning and management experience is advantageous.

• Authorization to work in the United States is required.

🏝️ Benefits

• Work-life balance, flexibility, and autonomy.

• Medical, dental, and vision insurance.

• Health and wellness initiatives.

• Parental leave and support.

• Assistance for adoption and surrogacy.

• Career development opportunities.

• Tuition reimbursement for ongoing education.

• 401k match with an annual company contribution.

• Annual Incentive Bonus based on corporate goal achievement and personal performance.

• Paid Time Off (PTO).

• Reasonable accommodations for applicants with disabilities.