Supervisor Pharmacist - Knoxville - CalOptima

    CalOptima
    CalOptima Knoxville

    1 day ago

    $115,000 - $155,000 (USD) per year *
    Description
    Supervisor Pharmacist
    CalOptima
    Join Us in this Amazing Opportunity
    The Team You'll Join

    We are a mission driven community‐based organization that serves member health with excellence and dignity, respecting the value and needs of each person.

    If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all.

    More About the Opportunity
    We are hoping you will join us as a

    Supervisor Pharmacist

    and help shape the future of healthcare where you'll be an integral part of our

    Pharmacy Management


    team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders.

    This position has been approved to be

    Full Telework .

    If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum.


    The Supervisor Pharmacist for Pharmacy Clinical Programs will assist the manager and pharmacy staff with the ongoing development and implementation of targeted drug utilization and disease state management strategies to improve the quality of care and outcomes of health care provided to members.

    You will supervise pharmacy staff involvement with clinical programs such as Medication Therapy Management (MTM), Interdisciplinary Care Team (ICT), Pharmacy & Therapeutics (P&T) committee, Drug Utilization Review (DUR) and pharmacy quality, and supports the Pharmacy residency and internship programs.

    You will promote clinically appropriate prescribing practices by continuously researching and developing drug management intervention strategies. Together, we are building a stronger, more equitable health system.

    Your Contributions To the Team:
    50% ‐ Supervisory Functions

    Participates in a mission‐driven culture of high‐quality performance, with a member focus on customer service, consistency, dignity and accountability.

    Assists the team in carrying out department responsibilities and collaborates with others to support short‐ and long‐term goals/priorities for the department.

    Supervises day‐to‐day activities of the department to ensure compliance with company policies and regulatory requirements.
    Resolves complex matters, ensures team members are directed to the appropriate resources and manages escalated situations.
    Supervises, advises, trains and facilitates the ongoing development and education of department staff.
    Develops, establishes and maintains a work priority system to ensure Clinical Programs staff workloads are fulfilled.
    Develops and maintains contacts and relationships with key providers to interaction and intervention activities.
    Updates and maintains protocols and criteria for clinical and quality programs.

    Works with the Manager Clinical Pharmacist (Clinical Programs) to implement changes in regulations; updates CalOptima Health pharmacy policies and develops new policies and procedures when needed.

    Collaborates with the Manager Clinical Pharmacist (Clinical Programs) to recommend, develop and implement targeted drug utilization intervention programs and other DUR/DUE activities.

    Works with the Manager Clinical Pharmacist (Clinical Programs) and within Medical Management (e.g., with data manager, case managers, etc.) on various data integration and disease management and outcomes projects.

    Supports the pharmacy residency and internship programs and ensures successful completion of annual residency research projects.

    45% ‐ Program Support


    Collaborates with regulatory compliance and audit teams to ensure the pharmacy clinical programs meet expectations, develops processes, program and training materials exceed established standards and works with Manager Clinical Pharmacist (Clinical Programs) to improve or implement new Centers for Medicare & Medicaid Services (CMS) guidance, Department of Health Care Services (DHCS) and/or National Committee for Quality Assurance (NCQA) regulations into operations and workflow.

    Reviews members' medication profiles to meet various clinical and quality program requirements; makes recommendations to health care providers based on evidence‐based medicine and national guidelines for disease management.

    Collaborates with PBM to implement and address formulary, systems and other member drug benefit‐related programs.

    Serves as point of contact for clinical programs that address member drug utilization or CMS programs such as MTM, ICT, DUR, Healthcare Effectiveness Data and Information Set (HEDIS) & Star, and other targeted clinical programs based on department initiatives.

    Assists in the preparation of drug monographs and utilization reports for the Pharmacy & Therapeutics Committee.
    Represents Pharmacy Management in interdepartmental meetings.
    Participates with work groups to provide pharmacy subject matter expertise.

    5% ‐ Completes other projects and duties as assigned.

    Do You Have What the Role Requires?
    Doctor of Pharmacy (PharmD) degree from a fully accredited university required.

    3 years of experience in managed care clinical programs required.

    Current knowledge and expertise in clinical pharmacology and disease states are required.

    Demonstrated proficiency in pharmacy data analytics required.

    Basic working knowledge of Medicare Part D and Medi‐Cal required.

    You'll Stand Out More If You Possess the Following:
    Supervisory experience.

    CMS, Department of Managed Health Care (DMHC) and/or NCQA audit experience.

    Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Farsi, Chinese, Korean, Russian, Spanish, Vietnamese).

    Pharmacy Residency in managed care or pharmacy practice.

    What the Regulatory Agencies Need You to Possess?
    A current, valid and unrestricted California state registered pharmacist license.

    Your Knowledge & Abilities to Bring to this Role:


    Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.

    Work independently and exercise sound judgment.
    Communicate clearly and concisely, both orally and in writing.
    Work a flexible schedule; available to participate in evening and weekend events.
    Organize, be analytical, problem‐solve and possess project management skills.
    Work in a fast‐paced environment and in an efficient manner.
    Manage multiple projects and identify opportunities for internal and external collaboration.
    Motivate and lead multi‐program teams and external committees/coalitions.
    Utilize computer and appropriate software (e

    g, Microsoft Office:
    Word, Outlook, Excel, PowerPoint) and
    * This salary range is an estimation made by beBee
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