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Centene Corporation Manager, Clinical Pharmacy Operations - OHIO Remote in Columbus, Ohio

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

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.

  • Directs and manages clinical pharmacy activities through subordinate staff to enhance the quality of pharmaceutical care and promote cost-effective utilization of pharmaceuticals for Health Net 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 Medi-Cal 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 most safe and effective pharmaceuticals and/or implementation of effective programs.

  • Oversees compliant administration of the Health Net pharmacy benefit.

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

Our Comprehensive Benefits Package:

  • Flexible work solutions including remote options, hybrid work schedules and dress flexibility

  • Competitive pay

  • Paid Time Off including paid holidays

  • Health insurance coverage for you and dependents

  • 401(k) and stock purchase plans

  • Tuition reimbursement and best-in-class training and development

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.

License/Certification:

Must have and maintain current, valid and unrestricted state Registered Pharmacist License for assigned region(s).

For Centene Forward only:

Current State's Pharmacist license not required.

o Engage with health plan pharmacists to build conviction for savings and implementation (e.g., 1:1 sessions/calls) of Centene Forward (CF) initiatives

o Coordinate with health plan pharmacists and contracting teams to ensure pharmacy is included in future negotiations and strategy across LOBs. Troubleshoot and act as thought partner to Pharmacy Strategy team members and health plan pharmacists

o Collaborate with VP of Health Plan Pharmacy Strategy and CF team to expand list of CF pharmacy opportunities and initiatives

o Coach health plan pharmacists on building financial and business case for pharmacy initiatives (e.g., some overlap with monthly LAG calls, HBR initiative tracking, AOP planning)

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.

TITLE: Manager, Clinical Pharmacy Operations - OHIO Remote

LOCATION: Columbus, Ohio

REQNUMBER: 1260865

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