Manager, Clinical Pharmacy Operations

Centene Management Company LLC; Louisiana; Hybrid; USD 108,000 - 199,000; Full time

Benefits offered by this job

Health insurance

Tuition reimbursement

Remote work flexibility

Job summary

Centene Management Company LLC seeks a Manager of Clinical Pharmacy Operations to lead clinical programs, drive formulary and drug utilization initiatives, and collaborate with regulators and leaders across departments. The role prioritizes high-quality pharmaceutical care and cost-effective utilization for Louisiana Medicaid, with remote work options and a requirement to reside in Louisiana.

You will oversee three direct reports and work Monday–Friday during Central Time business hours,

Qualifications

• Doctor of Pharmacy degree from an accredited school.
• 1–3 years clinical pharmacy experience including formulary development, drug utilization review, and/or medication therapy management.
• Four years progressively responsible positions within managed care pharmacy with at least two years in a management role.
• Public speaking experience.
• Must reside in Louisiana and hold an active Louisiana pharmacist license; willingness to travel to Baton Rouge as required.

Responsibilities

• Support Government Relations with pharmacy-related legislative talking points and meetings as needed.
• Collaborate on provider engagement and clinical strategies.
• Participate in monthly Lag Prep and pharmacy metric reviews.
• Ensure compliance with Louisiana clinical policy guidelines and Drug Information requirements.
• Maintain policies and procedures for Medicaid pharmacy business processes.
• Monitor CPS compliance with the Louisiana Medicaid contract.
• Direct and manage clinical pharmacy activities through subordinate staff to enhance quality and cost-effective utilization of pharmaceuticals for members.
• Develop, implement and maintain clinical pharmacy programs including clinical quality assurance, formulary management, drug utilization review, compliance and/or education.
• Coordinate clinical efforts with other department functional areas to ensure cohesive programs.
• Perform quality assurance monitoring of staff to ensure best practices and compliance with regulatory standards (Medicare Star, HCQA, HEDIS).
• Oversee and/or develop clinical recommendations and guidelines for Pharmacy and Therapeutics committee approval.
• Monitor clinical advancements and changes to ensure safe and effective pharmacotherapy and program implementation.
• Oversee compliant administration of the pharmacy benefit.
• Act as clinical pharmacy liaison to outside agencies and providers; primary contact for the area on clinical pharmacy issues.

Skills

Leadership

Change management

Managed care experience

PBM experience

Microsoft Office proficiency

Public speaking

Communication skills

Education

Doctor of Pharmacy

Active LA Pharmacist License

Tools

Microsoft Office

Job description

Position Purpose

The Manager of Clinical Pharmacy Operations is responsible for developing, implementing and administering clinical pharmacy tools and programs to support corporate and regional drug utilization and financial goals.

Key Details

This remote Pharmacist position supports the Louisiana Medicaid pharmacy program and requires candidates to reside in Louisiana. This position leads three direct reports, including a pharmacist, pharmacy coordinator, and project coordinator. The role operates Monday through Friday during Central Time business hours and serves as a pharmacy subject matter expert, partnering with Louisiana Medicaid regulators, health plan executive leadership, Government Relations, Quality, Finance, and Actuarial teams on regulatory requirements, pharmacy initiatives, quality measures, financial planning, and member health outcomes.

Responsibilities

• Support Government Relations with pharmacy-related legislative talking points and meetings as needed.
• Collaborate on provider engagement and clinical strategies.
• Participate in monthly Lag Prep and pharmacy metric reviews.
• Ensure compliance with Louisiana clinical policy guidelines and Drug Information requirements.
• Maintain policies and procedures for Medicaid pharmacy business processes.
• Monitor CPS compliance with the Louisiana Medicaid contract.
• Direct and manage clinical pharmacy activities through subordinate staff to enhance the quality of pharmaceutical care and promote cost-effective utilization of pharmaceuticals for members.
• Develop, implement and maintain clinical pharmacy programs including but not limited to clinical quality assurance programs, formulary management, drug utilization review, compliance and/or education.
• Coordinate clinical efforts with other department functional areas to ensure implementation of cohesive programs.
• Perform quality assurance monitoring of staff to ensure best practices are met and validate that clinical pharmacy programs meet applicable regulatory and compliance standards, such as Medicare Star ratings, HCQA HEDIS measures, and/or regulations.
• Oversee and/or develop clinical recommendations and guidelines for approval by the Pharmacy and Therapeutics committee.
• Monitor clinical advancements and changes in evidence-based pharmacy practice to ensure appropriate coverage of the safest and most effective pharmaceuticals and/or implementation of effective programs.
• Oversee compliant administration of the pharmacy benefit.
• Act as clinical pharmacy liaison to outside agencies and providers as well as the primary point of contact for the responsible area on clinical pharmacy issues as needed.
• Perform other duties as assigned.
• Comply with all policies and standards.

Ideal Candidate

The ideal candidate will bring strong leadership and employee engagement skills, the ability to effectively lead through change, and significant managed care experience, preferably within pharmacy health plan leadership. Previous PBM experience is a plus, along with proficiency in all Microsoft Office applications.

Education/Experience

• Doctor of Pharmacy degree from an accredited school.
• One to three years clinical pharmacy experience including formulary development, drug utilization review, and/or medication therapy management.
• Four years progressively responsible positions within managed care pharmacy with a minimum of two years in a management role.
• Public speaking experience.

Additional Requirement for the State of Louisiana

The pharmacist must reside in Louisiana, hold an active Louisiana pharmacist license, work full-time and have at least five (5) years of experience practicing as a pharmacist in a retail setting, including managerial experience. Ability/willingness to travel to Baton Rouge, Louisiana as required.

License/Certification

Must have and maintain current, valid and unrestricted Registered Pharmacist License in the state of LA.

Pay Range

$107,700.00 - $199,300.00 per year

Benefits

• Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.
• Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.
• Total compensation may also include additional forms of incentives.
• Benefits may be subject to program eligibility.

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You'll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It's work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.

We provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well.