Manager, Clinical Pharmacy Operations

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 include supporting Government Relations with pharmacy-related legislative talking points and meetings as needed, collaborating on provider engagement and clinical strategies, participating in monthly Lag Prep and pharmacy metric reviews, ensuring compliance with Louisiana clinical policy guidelines and Drug Information requirements, maintaining policies and procedures for Medicaid pharmacy business processes, and monitoring CPS compliance with the Louisiana Medicaid contract. 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

Directs and manages clinical pharmacy activities through subordinate staff to enhance the quality of pharmaceutical care and promote cost-effective utilization of pharmaceuticals for members.

Responsible for the development, implementation and ongoing maintenance of clinical pharmacy programs including but not limited to clinical quality assurance programs, formulary management, drug utilization review, compliance and/or education.

Coordinates clinical efforts with other department functional areas to ensure implementation of cohesive programs.

Performs quality assurance monitoring of staff to ensure best practices are met and validates that clinical pharmacy programs meet applicable regulatory and compliance standards, such as Medicare Star ratings, HCQA HEDIS measures, and/or regulations, etc.

Oversees and/or develops clinical recommendations and guidelines for approval by the Pharmacy and Therapeutics committee

Monitors 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.

Oversees compliant administration of the pharmacy benefit.

Acts as clinical pharmacy liaison to outside agencies and providers as well as the primary point of contact for responsible area on clinical pharmacy issues as needed.

Performs other duties as assigned.

Complies with all policies and standards.

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.