Clinical Pharmacy Manager

HCSC Group; Albuquerque, Northern (NM, KY); Hybrid; USD 102,000 - 184,000; Full time

Job summary

Health Care Service Corporation (HCSC) is seeking a pharmacist leader to direct the development and oversight of clinical and operational programs for Medicare/Medicaid government pharmacy operations. This role collaborates with internal teams and external providers to improve quality, outcomes, and cost of care.

Responsibilities include governance of MTM initiatives, formulary review, and reimbursement methodologies while guiding performance across CMS Stars, Medicaid programs, and PBM

Qualifications

• Registered Pharmacist in the state.
• Experience in corporate pharmacy guidelines, formulary review and quality improvement.
• Knowledge of medication use evaluation principles.
• Drug information skills.
• Analytical skills.
• Experience with Windows-based word processing, spreadsheets and relational database software.
• Verbal and written communication skills.
• Ability to work at a desk for long periods and perform data entry.
• Multitask and manage communications professionally to resolve issues.

Responsibilities

• Direct and oversee development, maintenance, and oversight for clinical and operational programs in enterprise pharmacy government programs.
• Collaborate with management and external health care providers to improve quality and cost outcomes.

Skills

Pharmacist licensure

Pharmacist experience

Medication use evaluation

Drug information

Analytical skills

Communication skills

Multitasking

Window-based software

Tools

Microsoft Excel

Microsoft PowerPoint

Relational databases

Job description

Job Summary

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This Position Is Responsible For Directing The Development, Maintenance And On-Going Oversight For Clinical And Operational Programs And Processes For Enterprise Pharmacy Government Programs Of Medicare And Medicaid. This Includes But Is Not Limited To Cms Stars And Medicaid Quality Withhold Programs, Medicare And Medicaid Operational And Reporting Activity, Programs For Prescribers And Network Of Pharmacies, Pharmacy Cost And Utilization Trends Monitoring, Clinical Programs With Emphasis On Disease Management And Clinical Outcomes, Developing And Maintaining Reimbursement Methodologies For Pharmaceuticals, Oversight Of Contracted Pharmaceutical Benefit Managers (Pbm), And For The Overall Effectiveness Of The Government Pharmacy Operations And Programs. Additionally, This Position Requires Collaboration With Management And Professional Staff Within Hcsc And With External Health Care Providers To Improve Quality Of Healthcare, Optimize Health Outcomes And Improve The Cost Of Care.

Job Requirements

• Registered Pharmacist in the state.
• Corporate Pharmacist experience including experience with pharmacy practice guidelines or practice parameters; review of formulary programs, pharmacoeconomics; or pharmacy quality improvement processes/techniques.
• Knowledge of medication use evaluation principles.
• Drug information skills.
• Analytical skills.
• Experience using window based word processing, spreadsheet and relational database software.
• Verbal and written communications skills.
• Ability to remain at a work station and perform computer entry for long periods of time, as required.
• Skills to handle multiple priorities and manage communications professionally to achieve issue resolution with customers, employees, or management.

Preferred Job Requirements

• MTM program experience or completion of MTM/Pharmaceutical Care Training.
• Experience developing and implementing system tools.
• Experience with Microsoft excel and PowerPoint.
• Experience with Medicare Star measures.

Flex (Hybrid) role

This is a Flex (Hybrid) role: requires 3 days in office; 2 days remote #LI-AC1 #LI-Hybrid

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. Base Pay Range $102,000.00 - $184,300.00 Exact compensation may vary based on skills, experience, and location.

HCSC Employment Statement

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

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For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions.

Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.