VP, Pharmacy Services MCC
Job DescriptionAccountable for developing and implementing pharmacy programs across all products for Magellan Complete Care (Medicaid, Medicare, DSNP and LTSS), as well as leading the health plan pharmacy functions in partnership with the market plan presidents. The VP oversees all contracted services with pharmacy benefits managers (PBMs) to include pharmacy network optimization, cost of care activities, pharmacy program operations, quality performance, and oversight of pharmacy staff. Ensures all pharmacy utilization and quality management programs meet regulatory and contractual compliance standards.
- Leads team of pharmacists and staff across Magellan Complete Care markets in the successful implementation of pharmacy programs, ensuring alignment with MCC’s strategy and objectives
- Develops and implements pharmacy benefit programs in collaboration with medical leadership and market plan presidents; establishes and assists in execution of pharmacy clinical and value initiatives annually for each plan.
- Accountable for managing the relationship between MCC and the PBMs; establishes and maintains strict controls and accountability for all vendor delegation oversight.
- Analyzes data to assess and improve performance for cost of care initiatives and other program improvement opportunities aimed to improve care and/or control drug or overall healthcare costs.
- Oversees the review of monthly utilization data from the PBM, ensuring that financial and PMPM data is appropriate and analyzed prior to submitting to the Chief Medical Officer
- Optimizes the pharmacy network through contracting and network management
- Provides quality and clinical oversight to pharmacy programs, ensuring programs meet regulatory, accreditation and compliance standards
- Implements standardized Medication Therapy Management (MTM) program
- Collaborates with external and internal stakeholders in the successful implementation of pharmacy programs
- Leads pharmacy activities and strategy for Medicare stars rating performance
- Develops and monitors all pharmacy key performance indicators and metrics; manages cross functional accountability to meet regulatory compliance
- Develops and manages pharmacy budget
- Oversees collaboration with providers in implementing clinical pharmacy initiatives.
General Job Information
TitleVP, Pharmacy Services MCC
Job FamilyPharmacy Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date7/22/2019
Date Requisition Created7/22/2019
Work ExperienceManagement/Leadership, PBM (Pharmacy Benefit Management), Pharmacy
EducationBachelors: Pharmacy (Required)
License and Certifications - RequiredRPH - Registered Pharmacist - Pharmacy
License and Certifications - PreferredPharmD - Doctor Of Pharmacy, State Licensure - Pharmacy
Other Job Requirements
Experience developing value based and/or integrated pharmacy programs with providers
Programmatic experience related to behavioral health and associated pharmacy programs/knowledge
Advanced degree in Management e.g. MHA, MBA, or MPH preferred
- PharmD preferred.
- Bachelor’s in Pharmacy required
- Must have unrestricted Registered Pharmacist license
- 7+ years of experience as a clinical pharmacist, preferably in managed care or with a PBM
- 7+ years of pharmacy management experience within an MCO including leading pharmacy teams and developing strategy to manage cost of care and Stars programs
- 5+ years of experience in PBM clinical pharmacy initiatives
- Experience with Medicare guidelines
- Experience working in a highly matrixed organization
- Experience leading pharmacy utilization management function
- Experience in clinical program design and drug trend management
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.
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