Manager, Pharmacy Commercial Operations

Overview

At Quartz, we are transforming the future of healthcare with innovative health benefits designed to meet the evolving needs of our members. Our commitment to excellence and passion for improving patient outcomes drives everything we do. We are looking for a visionary leader to join our team and help us shape the future of pharmacy operations.

Are you a dynamic and strategic thinker with a passion for revolutionizing healthcare? Do you have a proven track record of leading a team within pharmacy operations in a fast-paced, innovative environment? If so, we want you to join our team as the Manager, Pharmacy Commercial Operations.

Benefits:

• Audit-ready culture that emphasizes aligning member needs with high-quality, compliant pharmacy health plan operations.

• Full-time virtual, telecommuting, work from home environment available, if preferred

• Starting annual salary range, based upon skills and experience: $91,100-113,000 plus robust total rewards package.

Responsibilities

• Monitor and direct the end-to-end operations of Commercial pharmacy program, benefit, and audits.

• Provide leadership, support and guidance to Commercial Specialist Team, Pharmacy Department, Clinical Services and Quartz Health Plan.

• Management and implementation of the Quartz Formularies for Commercial and HIX plans in collaboration with the PBM and the Quartz P&T Committee.

• Management of Quartz Medical Drug Program.

• Management of Quartz Pharmacy Programs.

• Clinical Client Consultancy, Sales Support and Client On-boarding.

• Trend Management and Reporting.

• Develop and directs standard operation procedures (SOPs) to govern the Pharmacy Commercial Operations area.

• Ensure compliance of pharmacy benefit management activities with appropriate regulatory (OCI, DOI, CMS, DHS) and accreditation (NCQA) organizations in collaboration with internal areas, including assessment of new pharmacy requirements and determine appropriate compliance strategies and implement.

• Provide support and serve as a subject matter expert on pharmacy related member, client, audit and vendor activities, as required.

Qualifications

• Bachelor's or Associate's degree in pharmacy or related field.

• Certified Pharmacy Technician License.

• 8+ years of health plan or pharmacy benefit management experience.

• Two years of people leadership, supervisory experience.

• Strong interest in operational pharmacy services leadership.

• Familiar with clinical program components, formulary designs, and prescription drug benefit trends.

• Able to demonstrate skills in prioritization, problem solving & critical thinking, team building, decision making, time management and strategic planning.

• Exercise sound judgment in handling assigned tasks, including maintenance of strict confidentiality.

• Knowledge of laws and regulation regarding pharmacy.

• Knowledge of external pharmacy related quality and performance metrics.

• Create strong relationships and provide positive experiences for internal partners.

• Excellent oral and written communication skills.

• Excellent organizational and interpersonal skills.

This position has the flexibility to work remotely or in a hybrid environment at our office in Madison, WI. Hardware and equipment will be provided by the company, but candidates must have access to high-speed, non-satellite Internet to successfully work from home.

Quartz offers an excellent benefit and compensation package, opportunity for career advancement and a professional culture built upon the foundations of Respect, Responsibility, Relationships, and Resourcefulness. All employment offers are contingent upon successful completion of a pre-employment criminal background check.

Quartz values and embraces diversity and is proud to be an Equal Employment Opportunity, Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity or expression, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.