Director Pharmacy Utilization Management Houston TX
Location: Louisville, Kentucky
Description: The Job Junction is at present recruited Director Pharmacy Utilization Management Houston TX right now, this position will be reside in Kentucky. Detailed specification about this position opportunity kindly see the descriptions. The Director of Pharmacy Utilization Management directs and coordinates all pharmacy plans for a major regional Houston based administra! tor of self funded medical plans for large employers companies with 100 employees and other employer healthcare solution offerings â€" including:
Industrial Rehab and Pain Management
Occupational Injury Management
Occupational Medicine Services
Comprehensive Health & Wellness Services
This company is a unit of one of the largest and most respected Integrated Health Systems in the country
The Pharmacy Director is responsible for managing ongoing contract relationships conducting pharmacy benefit analysis and providing consultation to the Medicare Part D and commercial drug utilization management programs He she is responsible for the leadership oversight and development of pharmacy utilization and formulary programs
This position reports to the Chief Operating Officer and offers excellent compensation â€" up to 170 000 in base salary plus 20 30 annual performance bonus
Pharmacy Director ’s Core Respons! ibilities
Responsible for all aspects of pharmaceutic! al contracting and pricing including development implementation and maintenance
Oversees and manages the pharmacy benefits manager PBM contract amendments addendums specialty pharmacy agreements including the monitoring of contract compliance and auditing of current network rates to ensure that appropriate reimbursement rates are being applied
Participates in new program implementations including designing and implementing processes and initiatives in collaboration with pharmacy vendors to develop appropriate goals and strategic plans to manage pharmacy cost
Define establish and maintains all plan formularies Performs high complex research and analysis related to prescription drugs and their applications in support of formulary development and the prior authorization program Monitors current and emerging trends in formulary utilization management strategies
Ensures contract compliance and performs analysis regarding pharmacy claims and pu! rchasing data to identify contracting opportunities Identify and make recommendations when opportunities for improvement in operational processes and program structures are available
Prepares annual budget control and reduce costs forecast operational needs and review expenditures to ensure budget limits are not exceeded Serve on Medical Cost Committee
Establish scope of services and develop annual implementation plans which contribute to organizational strategic objectives Provides subject matter expertise and collaborates with providers management client and vendors on pharmacy issues in order to maintain client and provider service level commitments and meet financial performance guarantees
Designs and implements projects programs and initiatives to improve program processes to ensure compliance with contractual and regulatory requirements Identifies and maintains compliance standards for URAC NCQA as well as state and federal agencies
! Communicate with staff and promote staff ownership in problem solving ! and participation in operational decision making
Serve on interdisciplinary committees to provide leadership in identifying problematic prescription patterns drug utilization review prior authorization and quality assurance programs
Ensures safe care to patients staff and visitors; adheres to all corporate policies procedures and standards within budgetary specifications including time management supply management productivity and quality of service
Promotes individual professional growth and development by meeting requirements for mandatory continuing education and skills competency; supports department based goals which contribute to the success of the organization; serves as preceptor mentor and resource to less experienced staff
MINIMUM QUALIFICATIONS :
BS in Pharmacy PharmD is preferred
Minimum of 7 years of experience in pharmacy network operations contracting pricing and pharmacy benefit management
Vali! d pharmacist license without restrictions and commitment to obtain licensure by the Texas State Board of Pharmacy within a year of employment
Experience with health care contracting pharmacy benefit managers Medicare and Medicaid plans Healthcare Exchanges benefit design and cost containment strategies and previous staff management experience
Strong research analytical and problem solving capabilities
Ability to solve problems establish trust and credibility and deal effectively with change
Proficient in word processing spreadsheets and databases Excellent verbal and written communication skills Interacts independently with all levels of the organization and external partners
Demonstrate commitment to integrate the culture of the parent Health System into all internal and external customer interactions and deliver on our brand promise to advance health through innovation accountability empowerment collaboration compassion and res! ults
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If you were eligible to this position, please sen! d us your resume, with salary requirements and a resume to The Job Junction.
Interested on this position, just click on the Apply button, you will be redirected to the official website
This position will be started on: Tue, 19 Nov 2013 23:41:50 GMT
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