Clinical Pharmacy Programs Manager (Managed Care)

Harris Health System, Inc.; Houston (TX); Híbrido; USD 110.000 - 160.000; Jornada completa

Descripción de la vacante

Community Health Choice, Inc. is seeking a Clinical Pharmacy Program Manager to lead integrated clinical pharmacy services and oversee PBM-related operations for the health plan.

You will supervise clinical pharmacists and technicians, analyze claims data, and guide medication management initiatives across Medicare/ Medicaid/ Marketplace lines, ensuring regulatory compliance and optimal care. The role reports to the Director, Pharmacy Analytics-CHC and collaborates with Care Management and

Formación

• Active Texas pharmacist license required or licensure to be obtained before start date.
• Doctor of Pharmacy degree preferred.

Responsabilidades

• Review claims data to identify utilization management opportunities and cost-savings.
• Perform prior authorization reviews and appeals.
• Oversee Medication Therapy Management (MTM) program and supervise pharmacy staff.
• Support Care Management and Utilization Management on medication-related projects.

Conocimientos

Leadership

Communication

Analytical thinking

Attention to detail

Problem solving

Educación

Doctor of Pharmacy (PharmD)

Texas pharmacist license

Herramientas

SQL

Microsoft Excel

Microsoft Office

Visio

Descripción del empleo

Community Health Choice, Inc. is seeking a Clinical Pharmacy Program Manager to lead integrated clinical pharmacy services and oversee PBM-related operations for the health plan.

You will supervise clinical pharmacists and technicians, analyze claims data, and guide medication management initiatives across Medicare/ Medicaid/ Marketplace lines, ensuring regulatory compliance and optimal care. The role reports to the Director, Pharmacy Analytics-CHC and collaborates with Care Management and