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Albuquerque, NM Full Time Posted by: America's Health Insurance Plans (AHIP) Posted: Thursday, 2 April 2020
 
 

Provides comprehensive management and leadership for the Presbyterian Health Plan (PHP) Pharmacy Department. Manages the PHP pharmacy benefit for all product lines. This includes oversight of the prior authorization process, formulary management, and regulatory compliance. Coordinates clinical programs and services offered by the department including educational programs for members, providers, and PHP staff.
Responsibilities:
Initiates and follows through with the annual strategic planning process which includes the development of all strategic objectives and tasks for the department, creation and implementation of written work plans for all major tasks and tracking to ensure maintenance of timelines for completion of tasks.
Ensures optimal performance of all PHP Pharmacy Department functions including but not limited to:
Oversight of PBM for Prior Authorization process.
Drug utilization reviews and identification of areas for improvement.
Management of the PHP formularies
Coordination and Facilitation of PHPs Pharmacy & Therapeutics Committee.
Educational programs for members to enhance knowledge, compliance, and cost-effective therapy.
Functions as the Pharmacy Department lead in interactions with other PHP departments to provide assistance with their functions including UM, care coordination, Quality, Measurement Improvement, marketing, enrollment, provider services, and other functions as indicated.
Consultation in the development of Disease Management programs.
Reporting of drug utilization patterns to delegated physician groups.
Evaluates per member per month pharmacy costs and develops innovative mechanisms to favorably affect these costs while maintaining or improving quality of care.
Supports PHP efforts in regulatory compliance as these requirements or standards relate to the pharmacy department function.
Serves as the liaison between the PHP Pharmacy Department and external organizations such as state medical societies, pharmacy organizations, OSI, HSD, and other MCOs, to promote the best interests of PHP.
Performs other functions as required.
Requirements:
Doctorate degree in Pharmacy (PharmD.) or Registered Pharmacist (RPh) with extensive clinical experience.
New Mexico Board of Pharmacy License required.
Minimum of 5 years experience in a Clinical Setting and a minimum of five years experience in managed care or associated field preferred.
Health Plan Pharmacy leadership experience required.
Residency and Board Certification preferred.
Benefits
Benefits are effective day-one and include:
Competitive salaries
Full medical, dental and vision insurance
Flexible spending accounts (FSAs)
Free wellness programs
Paid time off (PTO)
Retirement plans, including matching employer contributions
Continuing education and career development opportunities
Life insurance and short/long term disability programs


Albuquerque, NM, United States of America
Healthcare, Science
Click apply
JS7750_7370257
4/2/2020 5:55:28 PM

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