Description
Provides oversight of all contracts, addendums, pharmacy registration and credentialing processes pertaining to 340B contract pharmacy, in-house retail pharmacy, clinic medication/vaccine, and 340 Program. Provides oversight and supervision of all auditing practices conducted as required by regulatory agencies. Acts as Primary Contact for HRSA/OPA, DEA, OHA VFC, NCPDP and OBOP.
340B Program Management
Serves as primary internal and external program manager and liaison for all 340B-related matters.
Ensures that 340B policies and procedures are developed and implemented according to organizational, regional, state, and federal requirements and guidelines.
Actively engages with senior leadership and participates in decision-making processes related to 340B implementation, oversight, and compliance processes.
Ensures that the 340B pharmacy program is continuously compliant with 340B federal regulations and maintains knowledge of the policy changes that affect the 340B program, including, but not limited to, HRSA/OPA rules, HRSA recertification, HRSA Database and Medicaid changes.
Develops, executes, and documents self-audits of the 340B process. Monitors 340B compliance within workflow processes. Coordinates and ensures remediation of findings as point-person for all audits.
Evaluates 340B contracts. Makes recommendations for contract maintenance and negotiations.
Manages relationships, billing services, and compliance with contracted 340B pharmacies.
Provides oversight for process improvement initiatives, creating an environment that places an emphasis on continuous monitoring and improvement including assessing opportunities for cost savings, business and system improvements.
Ensures that reporting meets organizational, regional, state, and federal requirements and guidelines.
Monitors for 340B pricing exclusions or shortages and establishes appropriate alternative products that are included where possible, including work with medical staff and formulary to ensure proper position and related use.
Oversee and direct 340B Coordinator to develop and deliver 340B program communication, staff training and education
Oversee and direct 340B Coordinator on 340B program projects, optimization, and problem resolution.
Maintains relationship as primary contact for all Third-Party Administrators related to contract pharmacy
Registers as "Primary Contact" in OPAIS and maintains accurate representation of all entity-owned and contract pharmacies
Accompany Director of Pharmacy Services on monthly Oregon Primary Care Association Pharmacy Leaders call
In-house Pharmacy Management
Oversee all pharmacy licensing and credentialing processes as required by state and federal agencies.
Reviews Oregon Board of Pharmacy licensure for each pharmacy staff member annually
Primary contact for maintaining current, new, and revoked CSOS certifications
Ensure all Pharmacy Benefit Manager contracts are reviewed, and enrollments are up to date.
Ensures pharmacy maintains compliance with all PBM contractual requirements.
Reviews wholesale drug distribution agreements and act as primary contact for drug wholesalers.
Provides oversight of prescription insurance claims reconciliation, reimbursement and profitability. Including MAC appeals when warranted
Partners with Director of Pharmacy to ensure all pharmacy policies and procedures are up to date and reflect current laws, rules and regulations as required by state and federal agencies.
Evaluates pharmacy inventory and supplies for potential cost-savings strategies
Works directly with retail pharmacy managers to ensure fiscally responsible inventory management
Collaborates directly with Director of Pharmacy to evaluate the financial performance of in-house pharmacy operations, including revenue growth, expense management, budget adherence, and potential additional revenue sources.
Partners with 340B Coordinator and accounting to review and reconcile Medicare Transaction Facilitator/Rebate Model payments, including submission of "good faith inquiries" when appropriate
Works directly with our in-house Third-Party Administrator to ensure accurate claims processing and inventory accumulations
Provides pharmacist staffing support within retail pharmacy operations during staffing shortages, vacations, sick calls, or other coverage gaps
In-house Pharmacy Management
Oversee all pharmacy licensing and credentialing processes as required by state and federal agencies.
Reviews Oregon Board of Pharmacy licensure for each pharmacy staff member annually
Primary contact for maintaining current, new, and revoked CSOS certifications
Ensure all Pharmacy Benefit Manager contracts are reviewed, and enrollments are up to date.
Ensures pharmacy maintains compliance with all PBM contractual requirements.
Reviews wholesale drug distribution agreements and act as primary contact for drug wholesalers.
Provides oversight of prescription insurance claims reconciliation, reimbursement and profitability. Including MAC appeals when warranted
Partners with Director of Pharmacy to ensure all pharmacy policies and procedures are up to date and reflect current laws, rules and regulations as required by state and federal agencies.
Evaluates pharmacy inventory and supplies for potential cost-savings strategies
Works directly with retail pharmacy managers to ensure fiscally responsible inventory management
Collaborates directly with Director of Pharmacy to evaluate the financial performance of in-house pharmacy operations, including revenue growth, expense management, budget adherence, and potential additional revenue sources.
Partners with 340B Coordinator and accounting to review and reconcile Medicare Transaction Facilitator/Rebate Model payments, including submission of "good faith inquiries" when appropriate
Works directly with our in-house Third-Party Administrator to ensure accurate claims processing and inventory accumulations
Provides pharmacist staffing support within retail pharmacy operations during staffing shortages, vacations, sick calls, or other coverage gaps
Vaccine and Clinic Medication Management
Works with Vaccine Coordinator to ensure policies, procedures, guides, and standing orders are developed and implemented according to organizational, regional, state, and federal requirements and guidelines for the Vaccine, Vaccine for Children (VFC), and Medication Management programs.
Acts as expert on OHA ALERT and VFC Regulations and primary contact for OHA/Oregon Immunization Program.
Oversees VFC Site Visits with OHA/VFC Inspector and Vaccine Coordinator, respond to follow-up email from visit with corrective action plan if there are any findings during the visit.
Acts as final determinant of vaccine viability regarding temperature and storage excursions for all clinic locations.
Attend Quarterly Deschutes County VFC Coalition Meetings and any other education and training specific to MA/RN VFC Coding and Compliance.
Partners with Vaccine Coordinator to develop and deliver vaccine and medication management program communication, staff training and education.
Partner with Vaccine Coordinator and Medication Coordinator on vaccine and medication management program process improvement initiatives, projects, and problem resolution.
Prescription Refill Specialist Supervisor Management
Provides leadership, oversight, and strategic direction for Prescription Refill operations to ensure safe, efficient, and patient-centered medication refill and prior authorization services across the organization.
Holds the Prescription Refill Specialist Supervisor accountable for team performance, operational metrics, staff engagement, workflow compliance, and departmental goals.
Provides leadership support and escalation management for complex medication access issues, insurance barriers (including prior authorizations), and formulary changes.
Partners with Prescription Refill Specialist Supervisor to oversee recruitment, onboarding, training, competency development, and retention strategies for Prescription Refill staff.
Collaborates with Providers, Nursing, Pharmacy, and IT/EHR teams to optimize medication access workflows.
Collaborates with Clinical Pharmacy Manager on implementation and oversight of refill protocols.
People Management
Manage performance of the team, conduct monthly meetups and provide real-time and consistent coaching with all direct reports.
Ensure accountability of team, including but not limited to adherence with policies, procedures, guidelines, workflows, etc., addressing attendance, performance, and behavior concerns including corrective action if necessary.
Consult with Human Resources to support employee relations, performance achievement, training, employee engagement, etc.
Hold consistent and timely team meetings to communicate organization, site, and/or department information, changes, initiatives, etc.
Obtain leadership approval and manage all recruitment and hiring for team. Provide oversight and support for recruitment/hiring of openings supervised by direct reports.
Manage time off requests and approve timecards for direct reports or as delegated and monitor to ensure staff take required breaks and lunches.
Effectively monitor onboarding of new hires, ensure on-going training and development for all staff.
Work Experience : A minimum of 5 years as a licensed pharmacist required. Retail Pharmacy experience required. Experience as pharmacist-in-charge preferred. People management experience preferred. Experience developing policy and procedures, workflows, and providing staff training preferred.
Education, certification and licensure : Doctor of Pharmacy or bachelor's degree in pharmacy required. Active Oregon Board of Pharmacy license required. CPR certification required. Valid Oregon driver's license required. Apexus Advanced 340B Operations certificate preferred.
Skills & Knowledge : Working knowledge of 340B program requirements required. Working knowledge of program management including experience with supporting continuous process improvement required. Must have excellent communication skills and ability to interact with a diverse population and professionally represent Mosaic Medical, strong teamwork and collaborative skills, ability to multi-task, attention to detail, excellent organizational skills, customer service, particularly in dealing with stressful personal interactions. Basic to intermediate ability and experience in computer applications, specifically electronic medical records system, Pharmacy software, and MS Office.
Who We Are
Mosaic Community Health prides itself on being an innovative health system that pioneers unique and creative ways to provide and improve patient access to health care. Since our founding in 2002 we have proudly served insured and uninsured patients regardless of age, ethnicity, or income.
We focus on a holistic approach to patient care by incorporating behavioral health, pharmacy, and nutrition support to serve patients in the most meaningful way. At Mosaic Community Health, you will work with incredibly dedicated and mission-centered peers and be part of a dynamic team based environment.
Mosaic Community Health offers more than just a job, it is a lifestyle. A lifestyle of serving others. A lifestyle of being an integral part of your community. A lifestyle that offers work/life balance. A lifestyle of enjoying the outdoors! Central Oregon offers over 300 days of sunshine a year, so enjoy a PTO day on the mountain, biking/hiking trails, or the river! A lifestyle that improves lives, including yours. Of course, we also offer a great benefit package!
Qualifications
Education
Required
Bachelors or better in Other
Licenses & Certifications
Required
Pharmacist
Experience
Preferred
5 years: A minimum of 5 years as a licensed pharmacist required. Retail Pharmacy experience required. Experience as pharmacist-in-charge preferred. People management experience preferred. Experience developing policy and procedures, workflows, and providing staff training preferred.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.
