Senior Manager, Clinical Pharmacy Operations

Centene Corporation • Indianapolis, IN • 14h ago

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Indiana candidates are highly preferred, but open to candidates within EST/CST time zones.

Position Purpose: Applies principles of evidence-based clinical pharmacy to analyze and develop Clinical Programs and Drug Utilization Review across Centene Pharmacy Solutions. Responsible for day-to-day operations, staff development and training, and including review of all DUR reports and clinical program outcomes.

Develop new clinical programs and analyze existing clinical programs

Direct and manage clinical pharmacy activities through subordinate staff to enhance the quality of pharmaceutical care and promote cost-effective utilization of pharmaceuticals

Oversight of programs for multiple plans in multiple states, managing to each state's regulations across multiple databases and efforts coordinated with multiple Quality Improvement (QI) teams

Responsible for the development, implementation and ongoing maintenance of clinical pharmacy programs including but not limited to clinical quality assurance programs, formulary management, drug utilization review, compliance and/or education.

Coordinate clinical efforts with other department functional areas to ensure implementation of cohesive programs

Assist in the development of quarterly prescriber educational materials for all Medicaid plans

Perform quality assurance monitoring of staff to ensure best practices are met, and validate that clinical pharmacy programs meet applicable regulatory and compliance standards, such as Medicare Star ratings, NCQA HEDIS measures, and Medicaid regulations, etc.

Oversee and/or develop clinical recommendations and guidelines for approval by the Pharmacy and Therapeutics committee or MCO DUR Board.

Serve as chairperson for the Clinical Programs/DUR Committee for regulatory oversight and the Clinical Programs/DUR Governance Committee

Monitor clinical advancements and changes in evidence-based pharmacy practice to ensure appropriate coverage of the most safe and effective pharmaceuticals and/or implementation of effective programs.

Oversee compliant administration of Envolve Pharmacy Solutions

Act as clinical pharmacy liaison to outside agencies and providers as well as the primary point of contact for Envolve Pharmacy Solutions on clinical pharmacy issues as needed

Develop new DUR (Drug Utilization Review) reports and analyze existing reports for trends

Create staff development and training

Performs other duties as assigned

Complies with all policies and standards

Education/Experience: Bachelor's degree in Pharmacy required; PharmD preferred. 2-5 years experience in a managed care pharmacy and management experience.Pay Range: $105,600.00 - $195,400.00 per year

Centene 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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

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