Manager, Clinical Pharmacy Initiatives (Richmond/Virginia Beach)

Company: Sentara
Location: Virginia Beach
Posted on: January 20, 2023

Job Description:

City/StateVirginia Beach, VAOverviewWork ShiftFirst (Days) (United States of America)Local: Must reside near Richmond, VA or Tidewater area for physician/employee meetings. Onsite 6-8 times per month, sometimes more or less.3 Years Managed care- Health Plan/PBM ExperienceExperience with Rebates and making formulary decisions regarding rebates. Experience working with ClientsProvide input and implement a strategic plan for Clinical Pharmacy, which includes helping to establishand meet short and long-term goals and managing the pharmacy trend and cost of care.1) Identify and implement innovative clinical cost of care and quality improvement initiatives for pharmacy and/or medical drugs. 2) Determines opportunities for improvements in clinical programs to manage cost of care from both a cost and utilization perspective. 3) Clearly communicate goals. 4) Provide analytical expertise on pharmacy reporting as needed. 5) Assist data analytics to support outcomes measurement for clinical pharmacy programs. 6) Support cross-functional efforts to drive and ensure timely and effective roll-out of changes. 7) Identifies and implements "best practices" for clinical pharmacy management. 8) Assist with the evaluation of clinical pharmacy performance to identify trends and opportunities for pharmacy cost and utilization improvements.Assists in the development, implementation, and management of clinical pharmacy programs and initiatives related to quality and care management.1) Work with pharmacy team and other internal partners to maintain NCQA accreditation levels and clinical pharmacy activities, including HEDIS and Medicare Stars. 2) Assists with the coordination of pharmacy care management programs as they relate to provider relationships. 3) Improve client, member, and provider satisfaction and experience. 4) Analyze data to identify and educate prescribers on practice trends, patterns, and opportunities for lower cost and improved quality as needed.Interface with external partners, providers, clients, members, or other customers to improve the overall stakeholder satisfaction of the pharmacy offering.1) Collaborates with cross-department/cross-divisional teams to achieve goals. 2) Responsible for the communication of department barriers and successes within the organization. 3) Promote successful communication channels for stakeholders with the pharmacy department.Manages existing and new market development by supporting the sale, implementation, and retention of the pharmacy benefit for Plan's commercial lines of business.1) Develop and analyze pharmacy utilization data, and transform data into client-facing information. 2) Collaborate across the organization to support development of pharmacy and utilization management strategy and reporting for employer groups. 3) Provide consultative services to employer groups regarding pharmacy benefits, customer/group audits, trends and strategic direction appropriate for their populations 4) Present data, analysis and information in client and sales meetings to HR Directors, Benefit Managers, Senior Client Leadership and brokers/consultants. 5) Provide business support of pharmacy strategies and solutions to the Sales and Marketing Team. 6) Contribute and manage completion of pharmacy content in request for proposals (RFPs) and request for information (RFIs), including formulary and network disruption analyses. 7) Consult with Sales and Pharmacy Operations to determine and correct implementation of client intent on standard and non-standard pharmacy benefits/programs.Job SummaryThis position will manage pharmacy program performance related to commercial client management/sale and provider relationships, such as physician value-based agreements and the pharmacy network. This position will report to the Director, Clinical Pharmacy and will require close collaboration with other pharmacy team members, as well as coordination with both the account management/sales teams and the overall Comprehensive Health Solutions team.

The Manager Clinical Initiatives will work with the Director of Clinical Pharmacy and the Director of Pharmacy Strategic Initiatives to present data on client specific trends and offer innovative solutions for clients. This includes current clients as well as prospective clients during the request for proposal process. This position will assist with the RFP process, including qualitative responses and analyses around formulary and network disruption. This position will also support provider relationships by providing data and education to enhance quality and affordability of care. This includes developing pharmacy reporting and meeting with providers to discuss opportunities and best practices in medication management.Qualifications:BLD - Bachelor's Level Degree: Pharmacy, DLD - Doctorate Level Degree: Pharmacy (Required)Managed Care, Management, PharmacistSkillsCommunication, Complex Problem Solving, Critical Thinking, Judgment and Decision Making, Leadership, Project Management, Results Oriented, Service Orientation, Strategic Thinking, Time ManagementSentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.In support of our mission "to improve health every day," this is a tobacco-free environment.

Keywords: Sentara, Virginia Beach , Manager, Clinical Pharmacy Initiatives (Richmond/Virginia Beach), Executive , Virginia Beach, Virginia