Remote Clinical Pharmacy Operations Manager

Centene Corporation; Sacramento (CA); Remote; USD 108,000 - 199,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work arrangements

Job summary

Centene Corporation is seeking a Manager of Clinical Pharmacy Operations to lead clinical pharmacy tools and programs aligned with corporate and regional goals. The role is fully remote and requires strong leadership in managed care or PBM operations, including formulary development, DUR, and prior authorization.

The ideal candidate has experience with Medicaid requirements, cross-functional teams, and regulatory compliance.

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.
• 4 years progressively responsible positions within managed care pharmacy with a minimum of two years in a management role.
• Public speaking experience.

Responsibilities

• Directs and manages clinical pharmacy activities through subordinate staff to enhance pharmaceutical care and cost-effective utilization.
• Develops, implements and maintains clinical pharmacy programs including quality assurance, formulary management, DUR, compliance and education.
• Coordinates clinical efforts with other department areas to implement cohesive programs.
• Performs QA monitoring of staff to ensure best practices and compliance with regulations and standards (Medicare Star, HCQA, HEDIS).
• Oversees and/or develops clinical recommendations and guidelines for Pharmacy and Therapeutics committee approval.
• Monitors clinical advancements to ensure coverage of safe and effective pharmaceuticals and program implementation.
• Oversees compliant administration of the pharmacy benefit.
• Acts as clinical pharmacy liaison to outside agencies and providers as needed.
• Performs other duties as assigned.
• Complies with all policies and standards.

Skills

People leadership

Managed care

PBM operations

Clinical edits

Drug utilization review

Prior authorization

Formulary management

Medicaid knowledge

Cross-functional collaboration

Public speaking

Education

Doctor of Pharmacy

Job description

Centene Corporation is seeking a Manager of Clinical Pharmacy Operations to lead clinical pharmacy tools and programs aligned with corporate and regional goals. The role is fully remote and requires strong leadership in managed care or PBM operations, including formulary development, DUR, and prior authorization.

The ideal candidate has experience with Medicaid requirements, cross-functional teams, and regulatory compliance.