We are seeking a Pharmacy Director who would like to work in an environment where active wear is welcomed and a great attitude is a must!
This position is based out of our Kaimuki office, where you would work typical business hours.
Some responsibilities include:
- Managing clinical aspects of Healthways-Hawaii Pharmacy program to ensure high-quality and cost-effective prescription drug benefits which includes benefit design, financial and clinical reporting, quality initiatives, formulary management, medication use policies, network contracting, drug rebates, financials, government programs and sales.
- Managing pharmaceutical costs and trends through analysis of industry, clinical and compliance laws and trends and provide leadership on cost containment opportunities.
- Oversight of Commercial, QUEST, and Medicare formularies, medication coverage policies, medication prior authorization, outreach, clinical coding.
- Design and manage clinical programs to obtain outcomes to maximize plan ratings for quality initiatives and delegated activities related to NCQA, HEDIS and Stars.
- Leadership and direction for implementation and pull-through for clinical service programs, formulary and utilization management activities.
- Ensure all clinical service areas meet contractual and regulatory requirements and deliverables, within budgetary parameters.
- Effectively lead a team of staff Pharmacists to ensure efficiency, effectiveness and high job satisfaction.
- Oversee relationship with external Pharmacy Benefit Management vendor (currently CVSC) and other vendors to ensure contract compliance and delivery of services consistent with standards of quality of care.
Basic requirements for the position:
The ideal candidate will:
- At least two years of PBM experience, health plan or managed care experience.
- Prior management experience.
- Strong verbal and written communication skills.
- The ability to juggle competing priorities and meet deadlines.
Only candidates who meet the minimum requirements for the position will be contacted for additional screening.
- Be knowledgeable on Medicare and Star ratings, HEDIS and NCQA.
- Design and manage formulary and clinical programs and drive quality metrics, in addition to develop PBM oversight functionalities related to formulary management and clinical programs and evaluate programs for clinical and financial value.
- Implement formulary and clinical program initiatives, while balancing priorities related to member and physician experience – i.e. Mitigating negative impact to members and physicians.
- Engage and navigate the unique relationship between our organization and our vendor partners. Have the ability to adapt to requirements of this unique triangle and for connections using sense of business understanding, asking questions and bridging gaps.
- Manage and grow staff – basic PBM oversight skill sets and their confidence with interacting with our partners.
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