Director, Pharmacy Services, MCC
Cambridge MA 02141 58 Charles Street
Job DescriptionResponsible for leading Magellan Complete Care's (MCC) efforts to develop the pharmaceutical strategy, to improve care and lower costs on the state program level. Tracks the appropriate metrics to demonstrate the quality and cost impact of all programs. Works with data management and clinical analytics to identify opportunities to improve the quality of care of pharmacy programs. Responsible for overseeing all pharmacy operations including delegated programs to ensure regulatory compliance and consistent application of benefits. Works with other pharmacy management clinical leadership to recommend, implement, and evaluate related clinical programs and services. Develops and maintains policies, procedures and processes that promote safe, efficient and cost-effective medication use in compliance with the guidelines set forth by the state, as well as all pertinent federal regulatory agencies and all accreditation bodies. Identifies staffing needs and supervises local staff. Supervises the Pharmacy Services Manager for the state office. In the absence of a Pharmacy Services Manager, MCC the Director is the primary contact for the state Medicaid program and for internal and external CMS compliance teams.
- Provides direction and oversight for the design, implementation, and ongoing administration of prescription drug benefits for our Medicaid and DSNP members, aligned with the strategy developed by senior leadership and in compliance with Medicare and Medicaid requirements.
- Provides clinical pharmacy direction for their state pharmacy team including, but not limited to medical economics, disease management, pharmacy drug utilization and quality management.
- Assists with the development, presentation, and implementation of policies and procedures consistent with the regulatory requirements of the contracts.
- Oversees third-party pharmacy vendors including Medication Therapy Management (MTM), Pharmacy Benefit Management (PBM), and Over-the-Counter (OTC) benefit.
- Monitors pharmacy utilization and produces informative reports to the state.
- Works with the state Medical Director and medical utilization management team, and oversees pharmacy team to ensure cost effective management of both medical and pharmacy utilization.
- Meets with the State Medicaid Regulators as required for Formulary review and required changes, program cost management, regulatory reporting, Drug Utilization reviews.
- May act as the POC and primary contact for state Medicaid regulators.
General Job Information
TitleDirector, Pharmacy Services, MCC
Job FamilyPharmacy Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date5/23/2019
Date Requisition Created5/23/2019
EducationBachelors: Pharmacy (Required), PharmD: Pharmacy
License and Certifications - RequiredRPH - Registered Pharmacist - Pharmacy
License and Certifications - Preferred
Other Job Requirements
- Previous experience in managed health care or Pharmacy Benefit Management environment preferred.
- Call center experience preferred.
- Current unrestricted state license required.
- Demonstrated customer service and analytical skills.
- Ability to use standard corporate software packages and corporate applications.
- 5-7 years' pharmacy experience required.
- 3-5 years' supervisory experience required.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.
Top 5 reasons to work at Magellan
Meaningful Work With People Who Care
At Magellan Health you can do meaningful work and feel confident that you matter in an organization that makes a real difference in the world - one that cares deeply and uses its employees’ collective insight as a competitive advantage.Read More
We are Compassionately Curious
Magellan Health is a place where we listen with real empathy. It’s one of our biggest strengths. It helps us to support each other and develop innovative solutions for the fastest growing, most complex areas of healthcare.Read More
We are Better Together
We rely on our innate ability to work as a high-functioning collaborative team to facilitate compassionate care to all of our members. With such interdependency comes trust, challenge and innovation.Read More
We believe work and life should flow together in unison. We offer resources that match your professional development, a culture that welcomes your ideas, and unparalleled flexibility to fit work around your life.Read More
Be your best at Magellan Health. We’re a collective of remarkably motivated and driven professionals. As a team, we’re proud of the high standards we set for each other and we’re continually inspired to do our best work.Read More
When you sayLife @ Magellan
To be the best you have to work with the bestWe hear you