Senior Clinical Services Director - Pharmacy
Location: Honolulu, Hawaii
Description: Healthways is at present recruited Senior Clinical Services Director - Pharmacy right now, this vacancy will be settled in Hawaii. Detailed specification about this vacancy opportunity please give attention to these descriptions. We are seeking a Senior Clinical Services Director, Pharmacy who would like to work in an environment where casual work attire is welcomed and a gr! eat attitude is a must!
This position is based out of our Kaimuki office, where you would work typical business hours.
Some responsibilities include:
Managing clinical aspects of Healthways-Hawaii Pharmacy program to ensure high-quality and cost-effective prescription drug benefits which includes benefit design, financial and clinical reporting, quality initiatives, formulary management, medication use policies, network contracting, drug rebates, financials, government programs and sales.
Managing pharmaceutical costs and trends through analysis of industry, clinical and compliance laws and trends and provide leadership on cost containment opportunities.
Oversight of Commercial, QUEST, and Medicare formularies, medication coverage policies, medication prior authorization, outreach, clinical coding.
Design and manage clinical programs to obtain outcomes to maximize plan ratings for quality initiatives and delegated acti! vities related to NCQA, HEDIS and Stars.
Leadership a! nd direction for implementation and pull-through for clinical service programs, formulary and utilization management activities.
Ensure all clinical service areas meet contractual and regulatory requirements and deliverables, within budgetary parameters.
Effectively lead a team of staff Pharmacists to ensure efficiency, effectiveness and high job satisfaction.
Oversee relationship with external Pharmacy Benefit Management vendor (currently CVSC) and other vendors to ensure contract compliance and delivery of services consistent with standards of quality of care.
Basic requirements for the position:
At least two years of PBM experience, health plan or managed care experience.
Prior management experience.
Strong verbal and written communication skills.
The ability to juggle competing priorities and meet deadlines.
The ideal candidate will:
Be knowledgeable on Medicare and Star rating! s, HEDIS and NCQA.
Design and manage formulary and clinical programs and drive quality metrics, in addition to develop PBM oversight functionalities related to formulary management and clinical programs and evaluate programs for clinical and financial value.
Implement formulary and clinical program initiatives, while balancing priorities related to member and physician experience â€" i.e. Mitigating negative impact to members and physicians.
Engage and navigate the unique relationship between our organization and our vendor partners. Have the ability to adapt to requirements of this unique triangle and for connections using sense of business understanding, asking questions and bridging gaps.
Manage and grow staff â€" basic PBM oversight skill sets and their confidence with interacting with our partners.
Only candidates who meet the minimum requirements for the position will be contacted for additional screening.
Qualific! ations
About Healthways:
Healthways is the largest ! independent global provider of well-being improvement solutions. Dedicated to creating a healthier world one person at a time, the Company uses the science of behavior change to produce and measure positive change in well-being for our customers, which include employers, integrated health systems, hospitals, physicians, health plans, communities and government entities. We provide highly specific and personalized support for each individual and their team of experts to optimize each participant's health and productivity and to reduce health-related costs. Results are achieved by addressing longitudinal health risks and care needs of everyone in a given population. The Company has scaled its proprietary technology infrastructure and delivery capabilities developed over 30 years and now serves approximately 40 million people on four continents.
Here at Healthways as we continue to make the world a healthier place, we have also created an environment where people choo! se to do their best work. Our unique culture thrives on mission-driven individuals who exude a high sense of energy and passion in everything that they do. Collaboration and teamwork are an essential part of everyday life for Colleagues who trust and depend on one another to achieve the highest degree of collective success. We are an organization that strives to recruit the best and the brightest individuals who take pride in the statement 'I work for Healthways.'
Healthways, Inc. is an equal employment opportunity employer and is committed to a proactive program of affirmative action and diversity development. Healthways, Inc. will continue to recruit, hire, train, and promote into all job levels without regard to race, religion, gender, marital status, familial status, national origin, age, mental or physical disability, sexual orientation, gender identity, source of income, or veteran status.
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If you were eligible to this vacancy, please deliver ! us your resume, with salary requirements and a resume to Healthways.
Interested on this vacancy, just click on the Apply button, you will be redirected to the official website
This vacancy starts available on: Fri, 01 Nov 2013 05:39:55 GMT
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