Remote Director, Clinical Pharmacy Operations - LA Medicaid

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

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,