Vice President, Pharmacy Operations

Centene; United States; Remote; USD 182,000 - 346,000; Full time

Job summary

A leading company in managed care seeks an Executive to oversee their pharmacy benefit management program. This role involves ensuring compliance across multiple product lines and managing vendor relationships while improving pharmacy service quality and achieving corporate goals with a focus on Medicare STAR ratings.

Benefits

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules

Qualifications

• 10+ years of clinical pharmacy care required.
• Previous management experience in pharmacy settings.
• Registered Pharmacist with an unrestricted license.

Responsibilities

• Oversee pharmacy operations, ensuring compliance and quality.
• Formulate and administrate policies for pharmacy services.
• Manage vendor relationships and oversee key contracts.

Skills

Pharmaceutical care

Management

Quality improvement

Regulatory compliance

Education

Bachelor's Degree in Pharmacy

PharmD

Job description

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.

Position Purpose:
Develop, implement and oversee the pharmacy benefit management program across multiple product lines in both centralized and regional environments with multiple locations. Ensure compliance with contractual guidelines of the corporation and health plans impacted by numerous regulatory agencies with complex and often conflicting requirements.

• Oversee the pharmacy operations for the business unit, including prior authorization, drug utilization review programs, lock in programs, and plan specific medical management initiatives
• Evaluate program performance and recommend to State on program changes that would result in improved costs and higher quality
• Formulate and administer related organizational policies and procedures, including pharmacy service quality, pharmacy utilization management and achievement of company goals for pharmacy and medical programs
• Responsible for developing and attaining pharmacy AOP initiatives and Per Member Per Month (PMPM) goal
• Establish the strategic vision, objectives and policies and procedures for the pharmacy program in support of the corporate strategic vision
• Establish necessary infrastructure and processes to ensure achievement of above average Medicare STAR ratings for all pharmacy measures
• Oversee the development and implementation of key contracts and ensure that relevant performance standards are met by vendors
• Oversee the resolution of disputes, grievances and complaints involving pharmacy program issues
• Participate in internal and external accreditation initiatives, relevant boards, task forces, committees, meetings and other activities
• Manage relationships with and provide appropriate oversight of key vendors, including pharmacy benefit management and pharmaceutical companies
• Support provider education initiatives such as provider profiling, provide participation in cost savings initiatives (appropriate switches to lower cost medications) and incentive programs
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience:
Bachelor's Degree in Pharmacy required, PharmD preferred
10+ years of clinical pharmacy care and experience required
Thorough knowledge of pharmaceutical care and pharmacy benefit management practices
Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff
Quality improvement experience preferred

Licenses/Certifications:
Registered Pharmacist with an unrestricted license in the state of employment with eligibility for pharmacy licensure elsewhere
Valid driver’s license may be required

Current unrestricted clinical license(s) (of if the license is restricted, the organization has a process to ensure job functions do not violate the restrictions imposed by the State Board

Pay Range: $182,100.00 - $345,600.00 per year

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.

Position Purpose:
Develop, implement and oversee the pharmacy benefit management program across multiple product lines in both centralized and regional environments with multiple locations. Ensure compliance with contractual guidelines of the corporation and health plans impacted by numerous regulatory agencies with complex and often conflicting requirements.

• Oversee the pharmacy operations for the business unit, including prior authorization, drug utilization review programs, lock in programs, and plan specific medical management initiatives
• Evaluate program performance and recommend to State on program changes that would result in improved costs and higher quality
• Formulate and administer related organizational policies and procedures, including pharmacy service quality, pharmacy utilization management and achievement of company goals for pharmacy and medical programs
• Responsible for developing and attaining pharmacy AOP initiatives and Per Member Per Month (PMPM) goal
• Establish the strategic vision, objectives and policies and procedures for the pharmacy program in support of the corporate strategic vision
• Establish necessary infrastructure and processes to ensure achievement of above average Medicare STAR ratings for all pharmacy measures
• Oversee the development and implementation of key contracts and ensure that relevant performance standards are met by vendors
• Oversee the resolution of disputes, grievances and complaints involving pharmacy program issues
• Participate in internal and external accreditation initiatives, relevant boards, task forces, committees, meetings and other activities
• Manage relationships with and provide appropriate oversight of key vendors, including pharmacy benefit management and pharmaceutical companies
• Support provider education initiatives such as provider profiling, provide participation in cost savings initiatives (appropriate switches to lower cost medications) and incentive programs
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience:
Bachelor's Degree in Pharmacy required, PharmD preferred
10+ years of clinical pharmacy care and experience required
Thorough knowledge of pharmaceutical care and pharmacy benefit management practices
Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff
Quality improvement experience preferred

Licenses/Certifications:
Registered Pharmacist with an unrestricted license in the state of employment with eligibility for pharmacy licensure elsewhere
Valid driver’s license may be required

Current unrestricted clinical license(s) (of if the license is restricted, the organization has a process to ensure job functions do not violate the restrictions imposed by the State Board

Pay Range: $182,100.00 - $345,600.00 per year

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.

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

About the company

Centene Corporation is a publicly traded managed care company based in St.

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