Senior Clinical Pharmacy Program Lead

Community Health Choice, Inc.; Houston (TX); Hybrid; USD 120,000 - 160,000; Full time

Job summary

Community Health Choice, Inc. seeks a Clinical Pharmacy Program Manager to lead integrated clinical pharmacy services for the health plan.

You will supervise clinical pharmacists, technicians and students, oversee UM strategies for high-cost drugs, and guide MTM initiatives across the organization. Responsibilities include reviewing claims data, prior authorization oversight, formulary strategy, and collaboration with Care Management and Utilization Management to support medication-related

Qualifications

• Licensed pharmacist in Texas or eligible to obtain license before start date.
• Doctor of Pharmacy preferred; Bachelor’s acceptable with certification.
• Minimum 5 years managed care pharmacy experience.
• Experience with drug utilization management required.

Responsibilities

• Review claims data to identify UM opportunities and cost-savings.
• Perform prior authorization reviews, appeals, and non-formulary decisions.
• Oversee MTM program and supervise pharmacy staff and students.
• Collaborate with Care Management, Utilization Management and Service Coordination.

Skills

Leadership

Analytical thinking

Attention to detail

Verbal and written communication

Problem solving

Education

Doctor of Pharmacy degree

Bachelor's degree in pharmacy

Tools

SQL

Microsoft Office

Excel

Visio

Job description

Community Health Choice, Inc. seeks a Clinical Pharmacy Program Manager to lead integrated clinical pharmacy services for the health plan.

You will supervise clinical pharmacists, technicians and students, oversee UM strategies for high-cost drugs, and guide MTM initiatives across the organization. Responsibilities include reviewing claims data, prior authorization oversight, formulary strategy, and collaboration with Care Management and Utilization Management to support medication-related