Jobs
>
San Diego

    Manager, Formulary Administration - San Diego, CA, United States - MedImpact Healthcare System

    MedImpact Healthcare System
    MedImpact Healthcare System San Diego, CA, United States

    2 weeks ago

    Default job background
    Description

    Manager, Formulary Administration & Strategy $110,714 - $155,000 - $199,286"Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.

    A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate." This position is not eligible for Sponsorship.

    MedImpact Healthcare Systems, Inc.

    is looking for extraordinary people to join our team Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork.

    We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

    At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care.

    We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making.

    Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry.

    We are the premier Pharmacy Benefits Management solution The Scoop:

    The Manager, Formulary Administration & Strategy is responsible for managing operational and strategic initiatives and projects, focuses on the development of programs and processes for formularies across all lines of business (Medicare, Medicaid, Commercial, and Health Insurance Exchange).

    This position plans and manages day-to-day activities of self and staff and continually monitors performance against department and company goals.


    What You Get To Do:
    Provides clinical, operational, supervisory guidance, and oversight to formulary administration and strategy staffDevelops formulary strategy and recommendations such as drug and UM positioning (e.g. quantity limit, step therapy, and/or prior authorization) in response to newly approved therapeutic agents, patent expirations, FDA alerts and drug recalls or withdrawals for Standard MedImpact formulariesProvides internal and external support for Proposals, Implementations, Audits and SalesAttends RFP Kickoff, Sales Optimization, Conception Forum, Implementation and Best and Final meetings if needed to provide consultation for onboarding a clientPerforms intake assessment and quality review of formulary work product prior to implementation and client distributionManages and supports inter and intra-departmental and external inquiries and requests surrounding the past plan year audits, the current plan year maintenance and the future plan year build concurrentlyReviews new drug categorization changes to customize, implement, and integrate with MedImpact formulary product as appropriateMonitors drug vendor and regulatory bodies for operational or strategic market changesStrategizes in collaboration with Industry Relations and Health Services to build pre-plan year formularies as well as maintaining current plan year formulariesIntegrates clinical, operational and CMS/States guidance expertise and perspectiveServes as Formulary representative on MedImpact Pharmacy and Therapeutics Committee, attends Formulary Committee meetings as a voting memberManages formulary activities related to MedImpact Standard and Custom formulariesManages formulary change process including appropriate formulary content, application of utilization management activities, printed formularies, Plan Finder formulary files and the functions as requiredEnsures that the review, coding and quality control of formulary changes occur in an appropriate, accurate, and timely manner based on client-specific parametersCollaborates with MedImpact's Government Program Services, Drug Information, Prior Authorization, Configuration Services, Rebates, Clinical Analytics, and Clinical Consulting teams to ensure accurate, cost-effective and up-to-date formulary contentManages negative formulary change process compliant to CMS/States guidance for MedImpact Standard formulariesProvides formulary-specific documentation of maintenance activities to clients and regulatory bodies as appropriateEnsures that policies and procedures and job aids are documented and followedManages, contributes to, and assists with current priority projects, programs, or initiatives as defined by leadershipCoordinates inter- and intradepartmental project activities and groups as necessary to meet project goals and timeframesPromotes rational and appropriate drug use in the Medicare populationProvides direct client clinical consultation relative to formulary drug placement, appropriate utilization management edits and related client specific web documents for Step Therapy and Prior Authorization Guidelines required by CMS/StatesProvides direct client consultation on CMS/States statutory regulations and CMS/States issued regulatory guidance to ensure continued CMS/States formulary approvalEnsures appropriate, accurate, and consistent client specific formulary claims adjudication, formulary flat file and Plan Finder file concordanceProvides direct client consultation on all Formulary Administration and Strategy operations, programs, and softwareResponsible for accurate and timely task estimation and status reporting to Director, Formulary Administration & StrategyExecutes within the confines and timeframes provided by CMS/States which may include non-standard business hoursSupervisory Responsibilities Directly supervises assigned staff in the Formulary Administration & Strategy departmentCarries out supervisory responsibilities in accordance with the organization's policies and applicable lawsResponsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problemsEducation and/or Experience For consideration candidates will need: Pharm D.

    from an accredited school of pharmacyFive (5) to seven (7) years' related experience and/or training; or equivalent combination of education and experienceLeadership experience may be substituted with four (4) years of MedImpact experience plus an appropriate external leadership training program and internal mentorship with a seasoned leader (Dir ) for current active employeesComputer Skills To perform this job successfully, the individual should have knowledge of Microsoft Office Suite Word Processing software.

    Certificates, Licenses, Registrations Valid Registered Pharmacist license in the State of California or equivalent state.

    Other Skills and Abilities Prior experience in PBM formulary setup and maintenance, relational and analytical database management programs, as well as, familiarity with First DataBank, Medi-Span and RxNorm drug files preferredPrior experience with Medicare Part D, Medicaid, Health Insurance Exchange and/or Commercial formulary development and maintenance processes highly desirableMust be able to execute and deliver within the confines and timeframes provided by CMS/States which may include non-standard business hoursPrior management experience preferred.

    Travel This position requires no travel; however, attendance may be required at various local conferences and meetings.


    The Perks:

    Medical / Dental / Vision / Wellness ProgramsPaid Time Off / Company Paid Holidays401K with Company matchLife and Disability InsuranceTuition ReimbursementEmployee Referral Bonus This position is eligible for Employee Referral Bonus at Level II To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California.

    Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.


    Equal Opportunity Employer, Male/Female/Disabilities/Veterans OSHA/ADA:
    To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


    Disclaimer:

    The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification.

    They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

    #J-18808-Ljbffr
  • MedImpact

    Formulary Administration Pharmacist

    1 week ago

    MedImpact San Diego, United States

    Exemption Status: · United States of America (Exempt) · $104,342 - $146,600 - $188,858 · "Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always de ...

  • Brown & Brown Insurance

    Director of Pharmacy Services- Remote

    6 days ago

    Brown & Brown Insurance San Diego, United States

    Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. · Piper Jordan is seeking a Director of Pharmacy Services for its growing team · Piper Jordan is a rapidly growing consulting firm offering ...

  • MedImpact Healthcare System

    Manager Medical Claims Administration

    2 weeks ago

    MedImpact Healthcare System San Diego, CA, United States

    Manager, Formulary Administration & Strategy · $innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of ...

  • Brown & Brown Inc Defunct

    Senior Pharmacy Consultant- Remote

    5 days ago

    Brown & Brown Inc Defunct San Diego, United States Full time

    Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. · Piper Jordan is seeking a Senior Pharmacy Consultant for its growing team · Piper Jordan is a rapidly growing consulting firm offering s ...

  • MedImpact

    Clinical Program Manager

    2 weeks ago

    MedImpact San Diego, United States

    Clinical Program Manager · $104,342 - $146,600 - $188,858 · "Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, ed ...

  • Brown & Brown, INC.

    Senior Pharmacy Consultant- Remote

    2 weeks ago

    Brown & Brown, INC. San Diego, CA, United States

    Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Piper Jordan is seeking a Senior Pharmacy Consultant for its growing team Piper Jordan is a rapidly growing consulting firm offering state- ...

  • Brown & Brown Insurance

    Senior Pharmacy Consultant- Remote

    2 weeks ago

    Brown & Brown Insurance San Diego, CA, United States

    Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. · Piper Jordan is seeking a Senior Pharmacy Consultant for its growing team Piper Jordan is a rapidly growing consulting firm offering s ...

  • MedImpact

    Clinical Program Manager

    2 weeks ago

    MedImpact San Diego, United States

    Clinical Program Manager · $104,342 - $146,600 - $188,858 · "Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, ed ...

  • Kaiser Permanente

    Outpatient Infusion Pharmacist

    1 day ago

    Kaiser Permanente San Diego, United States

    Job Summary: · The Outpatient Infusion Pharmacist provides comprehensive clinical and distributive pharmaceutical services. Under indirect, or direct supervision and based on the understanding of patient variables such as age, sex, and other physical characteristics: provides com ...

  • Select Specialty Hospital

    Pharmacy Technician

    1 week ago

    Select Specialty Hospital San Diego, United States

    Overview · Critical Illness Recovery Hospital · Pharmacy Technician · PRN/Per Diem/As Needed · Pay: $24.00/per hour · Location: Select Specialty Hospital San Diego · At Select Specialty Hospitals, a division of Select Medical, we care for chronically and critically ill or post-IC ...

  • Brown & Brown Insurance

    Senior Consultant

    2 weeks ago

    Brown & Brown Insurance San Diego, CA, United States

    Piper Jordan is seeking a Senior Pharmacy Consultant for its growing team · Piper Jordan is a rapidly growing consulting firm offering state-of-the-art employee benefits solutions to national employers. Provide value-added consulting experience on sophisticated pharmacy benefit p ...

  • Kaiser Permanente

    Inpatient Pharmacy Technician FT

    2 days ago

    Kaiser Permanente San Diego, United States

    : Job Summary: · Under direction of a licensed pharmacist, prepares, dispenses and distributes medications, pharmaceutical products, and intravenous admixtures, including hazardous drugs. Maintains pharmacy inventory and equipment. Assists other healthcare professionals by taking ...

  • MedImpact Healthcare Systems, Inc.

    PA Audit Specialist I

    2 weeks ago

    MedImpact Healthcare Systems, Inc. San Diego, United States Full time

    PA Audit Specialist I · $39,612 - $51,000 - $62,388 · "Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, educati ...

  • Southern Indian Health Council

    Clinical Pharmacist

    1 week ago

    Southern Indian Health Council Alpine, United States

    JOB ANNOUNCEMENT · Position Title: Clinical/Staff Pharmacist - Temp · Department: Pharmacy · Supervised By: Pharmacist in Charge · Location: Alpine/Campo · Status: Exempt, Salary · Post Date: May 7, 2024 · Closing Date: Until Filled · Compensation: $115, $169,790.94/year ...

  • Valor Healthcare

    Primary Care Nurse Practicioner

    6 days ago

    Valor Healthcare Escondido, CA, United States

    · Valor Healthcare is looking for a passionate Primary Care Nurse Practitioner to join our team at the Community Based Outpatient Clinic (CBOC) in Escondido, CA on a PRN basis. In exchange for your dedication and experience, we are proud to offer a competitive pay rate and excel ...

  • Kaiser Permanente

    Inpatient Pharmacy Specialist

    1 day ago

    Kaiser Permanente San Marcos, United States

    Job Summary: · Under indirect, or direct supervision and based on the understanding of patient variables such as age, sex, and other physical characteristics: monitors or manages the medication therapy of hospitalized or ambulatory patients as assigned; confers with and assists m ...

  • Kaiser Permanente

    Inpatient Pharmacy Specialist

    1 day ago

    Kaiser Permanente San Marcos, United States

    Job Summary: · Under indirect, or direct supervision and based on the understanding of patient variables such as age, sex, and other physical characteristics: monitors or manages the medication therapy of hospitalized or ambulatory patients as assigned; confers with and assists m ...

  • Kaiser Permanente

    Inpatient Pharmacy Specialist

    1 week ago

    Kaiser Permanente San Marcos, United States

    Job Summary: · Under indirect, or direct supervision and based on the understanding of patient variables such as age, sex, and other physical characteristics: monitors or manages the medication therapy of hospitalized or ambulatory patients as assigned; confers with and assists m ...

  • Kaiser Permanente

    Inpatient Pharmacist Specialist

    1 week ago

    Kaiser Permanente San Marcos, United States

    Job Summary: · Under indirect, or direct supervision and based on the understanding of patient variables such as age, sex, and other physical characteristics: monitors or manages the medication therapy of hospitalized or ambulatory patients as assigned; confers with and assists m ...

  • Valor Healthcare, Inc.

    Primary Care Nurse Practitioner

    2 days ago

    Valor Healthcare, Inc. Escondido, United States

    Job Description · Job DescriptionDescription:Valor Healthcare is looking for a passionate Primary Care Nurse Practitioner to join our team at the Community Based Outpatient Clinic (CBOC) in Escondido, CA on a PRN basis. In exchange for your dedication and experience, we are proud ...