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Director - Pharmacy

Expired Job

Mclaren Health Care Flint , MI 48555

Posted 2 months ago

Subsidiary: McLaren Health Plan -

McLaren Health Plan, recognized by Modern Health Care as one of the 100 Best Places to work for four years in a row, is seeking a Director of Pharmacy to join our team!

JOB SUMMARY

Responsible for all aspects of the pharmacy management process from the determination of the appropriateness of medications to ultimately improving health outcomes. Responsible for coordination with the Pharmaceutical Benefits Manger (PBM) for drug formularies design and development, risk management in a manner that will improve quality, control utilization and contain costs. Responsible for the education of the Medical Management staff for all product lines regarding pharmaceutical management. Manages pharmacy processes to be appropriate, compliant with NCQA standards and regulatory agencies and within budget. Develops and implements departmental policies and procedures as well as documentation of the utilization review processes, including pharmacy denial management. Responsible for the ongoing assessment and delivery of the Quality Improvement Performance Plan (QPIP) to facilitate meeting quality standards, with a focus on all NCQA standards with regards to pharmacy management. Intervenes with providers when prescribing patterns deviate from acceptable standards. Manages the day to day pharmacy interactions, including authorization and research of best practices for individual members and the overall pharmacy program. Works collegially with Medical Leadership and the PBM to identify opportunities for improved quality and cost-effectiveness in the management of the target population.

REQUIRED QUALIFICATIONS:

  • Pharm. D. or Bachelor of Science (R.Ph.)

  • Pharmacist with a valid, unrestrictive Michigan license

  • 5 years clinical pharmacy experience

  • 5 years pharmacy retail experience in a progressively more complex leadership role responsible for all forms of supervision of assigned staff;

  • Must have use of a personal vehicle for travel

PREFFERED QUALIFICATIONS:

  • Experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions (e.g. accounting/finance, reinsurance, EDI, marketing, administration, medical delivery, regulatory compliance, claims processing, membership/eligibility, contracting and risk arrangements and actuarial precepts).

NOTE: To further our mission of enhancing the health status of the individuals and communities we serve, effective February 1, 2013,McLaren Health Plan will no longer hire individuals who use tobacco or nicotine products in any form. Cotinine testing will be used to verify non-tobacco use. Individuals whose health screening results are verified positive for tobacco/nicotine use will be disqualified from employment, their job offer will be rescinded, and they will be disqualified from reapplying for employment for six (6) months from the date of the health screening.

  • Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities.

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Director - Pharmacy

Expired Job

Mclaren Health Care