Pharmacy Benefit Management Operations Manager

Job description

Operations Management:
• Manage day-to-day operations (24/7) in a cost- effective manner, delegate responsibility and authority for providing services, problem-solve issues identified by staff and internal/external stakeholders, and coordinate services in assigned areas with interdisciplinary teams.

Human Resource Management:
• Recruit, hire, train, develop, and supervise assigned staff, develop performance standards, and conduct performance reviews.

Program Design & Development:
• Develop and/or redesign programs, strategies, facilities and systems for service improvement or expansion. Lean Management: Practice of Performance Excellence (OPEX) for daily management and continuous improvement.

Process/Service Monitoring:
• Manage, coordinate/delegate, and schedule appropriate assignment of staff to meet workload demands while assuring availability of adequate resources.

Regulatory & Compliance:
• Manage, develop, implement, and maintain necessary policies and procedures, process improvements, training, and monitoring activities to ensure operations are compliant with appropriate laws, regulations, and organizational policies.

Teaching:
• Responsible for technician, pharmacist, student and resident training.
• PharmD or BPharm (with equivalent experience).
• Pharmacy Residency + 2 yrs work in managed care or PBM (or candidate with a minimum of five years equivalent experience).

Job Related Knowledge, Skills and Abilities (Competencies):
• Pharmacy benefit management including medication policy development, formulary development and benefit design
• Excellent communication, written and verbal
• Supervision of pharmacists and technicians and other staff
• Contemporary Pharmacy Practice
• Extensive knowledge of Medicare/Medicaid and Commercial Insurances
• MS, MBA,MPH,BCPS
• Managed care concepts and knowledge of benefit design and implementation and prior authorization workflows.
• Experience in clinical and/or business program development, Microsoft applications and project management
• Experience with PBM or health plan