FIND YOUR FUTURE
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.
Overview
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.
Qualifications
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.
Essential Accountabilities
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 (http://www.independenthealth.com/about/careers/additional-eeo-aap-information) for additional EEO/AAP or Reasonable Accommodation information.
Current Associates must apply internally via the Job Hub app.
The Independent Health Family of Companies, headquartered in Buffalo, NY, serves nearly 400,000 members and provides innovative health care products and benefits designed to engage consumers in their health and well-being. Established in 1980, our comprehensive portfolio includes Pharmacy Benefit Dimensions, Reliance Rx, Nova Healthcare Administrators, Care for You and the Independent Health Foundation.
Our culture sets us apart. Our core values drive who we are and the work we do. As a member of our family, you're part of something special, in your work and in the community.
We understand and appreciate that everyone has unique experiences, perspectives and identities which is why we pledge to create a safe space where all people and ideas are welcomed. We are here to continue learning and to generate important dialog.
We are committed to doing what matters most - reaching out, working together, and caring for our community. A healthy community benefits everyone who lives in it. You too can be part of making difference in the lives of others, together we achieve so much more. Please click here (http://www.independenthealth.com/about/community-report) to view our Community Reports.
Apply today and join us on the journey to a happier, healthier, and more inclusive community.
We are a drug-free workplace. We are committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans. An applicant for employment in need of an accommodation to participate in the application and recruitment process should contact Human Resources at: accommodations@independenthealth.com or Human Resources, 511 Farber Lakes Drive, Williamsville, NY 14221.
Please note, we do not accept unsolicited resumes. We do not accept resumes from headhunters, placement agencies, or other suppliers that have not signed a formal agreement with us.
