Manager, Pharmacy Clinical Operations – Clinical Configuration
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Mason • Ohio • United States
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About the role
- Oversees pharmacist and pharmacy intern associates developing and configuring prior authorization decision trees in the PA workflow tool.
- Oversees associate performance and quality assurance of prior authorization decision trees within the PA workflow tool.
- Provides clinical consulting services to internal partners.
- Assists in implementing clinical programs within the prior authorization space.
- Assists in the development of new clinical products.
- Oversees the Prior Authorization Center.
- Implements new prior authorization programs.
- Manages clinical pharmacy operations and staff to ensure clients' objectives and deliverables are met.
- Oversees departmental processes, policies and procedures, training, and communication.
- Reports and analyzes prior authorization program trends.
- Ensures achievement of department goals and objectives.
- Hires, trains, coaches, counsels, and evaluates performance of direct reports.
- Provides clinical consulting services to client and implements clinical information and education programs.
- Assists in developing formularies.
- Performs drug utilization analyses.
- Participates in and presents to Pharmacy and Therapeutics (P&T) committee meetings and management of client formulary.
Requirements
- Requires BA/BS in Pharmacy.
- Minimum of 4 years of experience as a pharmacist in a clinical setting; or any combination of education and experience, which would provide an equivalent background.
- Requires a registered pharmacist.
- Must possess an active unrestricted state license to practice pharmacy as a Registered Pharmacist (RPh).
- Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Benefits
- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short and long term disability benefits
- 401(k) + match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
clinical consultingprior authorization decision treesdrug utilization analysisformulary developmentclinical program implementationquality assuranceperformance managementclinical pharmacy operationsdata analysisprogram trend reporting
Soft skills
oral communicationwritten communicationinterpersonal communicationproblem-solvingfacilitationanalytical skillscoachingcounselingtrainingevaluation
Certifications
BA/BS in PharmacyRegistered Pharmacist (RPh)active unrestricted state license