You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.Senior Manager, Pharmacy Quality Initiatives (Pharmacist)Position Purpose: Provides clinical, compliance and quality related Pharmacy direction for Pharmacy Clinical Services within the Health Plan. Includes developing policies and procedures, working and ensuring pharmacy corporate compliance of initiatives driving pharmacy quality star ratings. Includes collaboration with internal and external partners (i.e: IT, Channel Communications, CSO, Pharmacy, initiative vendors). Participates in corporate committees. Chairs/leads committees as assigned. Responsible for the annual Pharmacy Residency Program. Mentors Residents and coordinates program activities.
Serves as SME for pharmacy quality measures, including validation of data presented at Corporate committees in conjunction with Corporate quality analytics team.
Develops maintains, reviews and oversees federal and/or state requirements and reporting functions of assigned clinical projects, and drives performance through partnership, leadership and open communication.
Presents pharmacy quality measure updates to key stakeholders within the markets (weekly, monthly, quarterly and annually via conference call, in-person presentations and metric reporting).
Implements and oversees various project management functions and works with appropriate individuals across the organization to ensure successful completion (clinical projects, medication/disease states, Pharmacy quality).
Attends and presents at various department and Corporate meetings. Prepares presentations for monthly, quarterly and annual meetings.
Acts as a liaison between pharmacy and Corporate compliance to ensure that all compliance related requirements are documented and develops CAPs if deficiency in assigned clinical processes is noted.
Develops work plans and process flows for Pharmacy Stars and other clinical programs.
Ensures policies and procedures in designated clinical area are reviewed, updated and presented to appropriate parties. This includes uploads to Corporate site (C360) as assigned.
Writes initial draft of clinical communications and works with Corporate communications departments to ensure that all department area specific communications are updated and posted in a timely fashion.
Provides necessary drug information, including drug utilization and evidence based medicine analysis, for use within assigned clinical areas and as education tools across departments as requested.
Responsible for oversight of multiple vendors (performance and relationship management). Sources new intervention vendors for quality measure improvements and makes recommendations to pharmacy leadership team.
Serves as the "Residency Coordinator" and is responsible for daily operations and performance of PGY-1 Managed Care Residency program. Ensures the program's national accreditation status is maintained.
Performs other duties as assigned.
Education / Experience : Bachelor's Degree in Pharmacy. Doctor of Pharmacy (PharmD), preferred. 3+ years of experience in Managed Care / Pharmacy Star Ratings, with 2+ years of experience in a leadership role / capacity and 5+ years in licensed Pharmacist role, OR completion of PGY-1 residency program + 2 additional years licensed Pharmacist role upon completion. Data analysis. Preferred Board Certification (i.e. BCPS) or other designations (i.e. CGP).Licenses and Certification: Licensed PharmacistWorking shift: 8am-5pm or 9pm-6pm Monday - Friday (EST).Job specific details:
Enhance development, execution, and launch of clinical programs
People leader dedicated to the growth, development and teaching of others
Improve program performance, enhance our initiatives and ultimately positively impact measure performance
Understanding of pharmacy quality measures PQA and HEDIS
Partner with team and business units to improve measure performance
Experienced with data and understanding large data sets
Managing data with the ability to summarize
Comfortable working in a fast-paced deliverable driven matrixed environment
Pay Range: $103,500.00 - $191,600.00 per yearCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.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.Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
