Manager, Pharmacy Operations

We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration.

The Manager-Pharmacy Operations will manage teams and resources dedicated to pharmacy system administration and reporting, vendor delegation oversight, medical pharmacy claims processing and training. They will establish and monitor performance and quality metrics and meet departmental, organizational, and regulatory targets. Additionally, the Manager will continuously look for opportunities to increase the efficiency and effectiveness of the area.

• Bachelor's degree required. An additional four (4) years of experience will be considered in lieu of degree.
• Five (5) years of relevant pharmacy operational experience required.
• Two (2) years of progressive leadership/management responsibility required.
• Experience in vendor oversight preferred.
• Background in compliance preferred.
• Strong leadership, analytical and mentoring skills, with ability to recognize and effectively address personnel issues in a fair and timely manner.
• Interpersonal and process management skills with the ability to recognize interdepartmental relationships and dependencies and implement departmental activity in support of cross-functional policy and procedure modification.
• Excellent written and verbal communication skills with the ability to focus and clarify concepts.
• Problem solving and decision-making abilities with an emphasis on analytical thinking.
• Effective organizational and time management skills and the ability to manage multiple projects and prioritize effectively.
• Working knowledge of core business systems preferred.
• Must exhibit initiative, decisiveness, and creativity, along with self-motivation with the ability to assume responsibility and maintain strict confidentiality.
• Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable.

Pharmacy System Operations

• Meet the reporting needs for the department for regular and ad hoc requests.
• Understand system capabilities and work collaboratively with the Pharmacy team to research, resolve, and implement solutions.
• Ensure regularity and integrity of pharmacy prior authorization correspondence, including relationships with print vendors to ensure timely delivery of correspondence.
• Assist in definition, design, development, documentation, and implementation of business processes to improve effectiveness and efficiency of the business operations as it relates to systems/applications.
• Work with Pharmacy leadership in maximizing the utility of departmental technology and systems and provide education/information related to system possibilities.
• Coordinate and test with IT and other IH departments for any changes to systems that integrate with pharmacy systems such as Macess, HealthRules and RxClaim.
• Accountable for development and production of regulatory reporting to meet/exceed audit requirements.
• Accountable for business need reporting to track metrics, efficiencies, productivity and to guide business decisions.
• Implement system updates and new vendor relationships and delegated operational functions.

Vendor Management

• Establish and maintain strong working relationship with clinical platform, cost transparency and delegated entity vendors to understand product roadmap, resolve issues, and create a partnership to maximize value.
• Engage vendor(s) as needed to provide professional services.
• Understand vendor contracts to know what is provided and to proactively work with IH vendor management and IT as contracts are renewed and/or new vendors are considered.
• Operational oversight of delegated pharmacy entities.
• Lead implementation of regulatory and business process changes with delegated entities.
• Oversee and coordinate audit activities with delegated entities.

Problem Resolution

• Collaborate with staff to predict, identify, resolve, and document problems.
• Assist team with identification and resolution of business and operational issues.
• Develop and maintain cross-functional relationships to bridge any organizational operational gaps.

Medical Pharmacy Claim Management

• Serve as pharmacy department subject matter expert on medical drug claims.
• Coordinate with pharmacy clinical team and system configuration to ensure medical drug claims are built and processed as intended.
• Maintain reference materials used by internal users and external providers for coverage of medical drugs.

Compliance and Training

• Oversee training development and delivery for relevant topics within the Pharmacy team.
• Ensure systems and vendors are compliant with all regulatory requirements including but not limited to CMS, DOH, DFS, and NCQA.

Immigration or work visa sponsorship will not be provided for this position

Hiring Compensation Range: $76,500 - $100,000 annually

Compensation may vary based on factors including but not limited to skills, education, location and experience.

In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future.

As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant's race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Click here for additional EEO/AAP or Reasonable Accommodation information.

Current Associates must apply internally via the Job Hub app.