Clinical Pharmacy Manager

HCSC; Tulsa (OK); Hybrid; USD 102,000 - 184,000; Full time

Job summary

Health Care Service Corporation (HCSC) seeks a Senior Pharmacist to direct development and oversight of enterprise government pharmacy programs, including Medicare and Medicaid, CMS Stars, and related reimbursement methodologies.

The role requires an active pharmacist license, strong analytics, and experience with PBMs, with a focus on improving outcomes while controlling costs across a national network.

Qualifications

• Registered Pharmacist in the state.
• Experience with pharmacy practice guidelines, pharmacoeconomics or PBM oversight.
• Knowledge of medication use evaluation principles.
• Drug information skills.
• Analytical skills.
• Experience with Windows-based word processing, spreadsheets and relational databases.
• Verbal and written communications skills.
• Ability to manage multiple priorities and professional communications.

Responsibilities

• Direct development, maintenance and oversight for enterprise pharmacy government programs (Medicare/Medicaid).
• Oversee CMS Stars and Medicaid quality withhold programs and related operations.
• Monitor reimbursement methodologies and pharmaceutical cost/utilization trends.
• Collaborate with management and external providers to improve quality and cost outcomes.
• Oversee contracted PBMs and overall government pharmacy operations.

Skills

Analytical skills

Drug information skills

Verbal communications

Written communications

Multi-tasking

MS Office

Education

Registered Pharmacist license (state)

Tools

MS Word

MS Excel

Relational databases

Job description

Flex

NM - Albuquerque

MT - Helena

OK - Tulsa

TN - Nashville

TX - Richardson

Full time

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.

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

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.

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.

Base Pay Range

$102,000.00 - $184,300.00

Exact compensation may vary based on skills, experience, and location.

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

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