Manager of Clinical Pharmacy Operations

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.

Job Posting Title

Manager of Clinical Pharmacy Operations

Job Description

This position provides administrative oversight and management of a site or line of business Prior Authorization (PA)/Utilization Management (UM) department responsible for managing the delivery of member and provider services. This position plays a key role in initiatives critical to achieving revenue goals and operational objectives. The position requires communication and teamwork across internal departments (account management, implementations, IT, quality, specialty pharmacy), in order to achieve objectives and SLAs. This position is also accountable for hiring, developing, mentoring, training and retaining staff.

Responsibilities

• Manages the pre-authorization process and customer service requirements to ensure compliance, quality and customer service level agreements are met.
• Manages and coordinates the activities of the team to efficiently manage the output of assigned tasks.
• Monitors the performance of team members by means of reports and observation.
• Assumes accountability for team conduct and productivity.
• Monitors individual team member’s attendance and reliability patterns.
• Administers performance improvement or corrective action plans when needed.
• Coaches, mentors and develops Team Leaders/Supervisors and staff with a focus on quality and accuracy of service.
• Works across divisional lines to ensure staff is properly trained and issues needing resolution are addressed timely.
• Creates a culture of support, accountability and continuous improvement.
• In collaboration with the Training Department, plans and develops training programs for department staff.
• As the end user and system expert, proactively suggests changes/updates to the prior authorization application that ensures maximum protocol adherence, documented medication savings, and increased health plan customer satisfaction.
• Possesses financial responsibility for meeting administrative budgets and the creation of innovative efficiencies.
• Assists divisional management with the implementation of improvement initiatives and new business implementations.
• Partners with Account Management and business clients to improve communications and address issues that may arise.
• For Managers assigned to Clinical Programs: Assists in completing calls for clinical, specialty clinical, account management and all other programs carried out by the clinical department. Assists in building out/organizing program protocol. Ensure all organizational documents are generated and cataloged according to internal protocols.

Minimum Qualifications

• Bachelor’s Degree, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required

• 6 years relevant experience
• 2 years experience in leadership / supervisory / people management

Must be eligible to work in the United States without the need for work visa or residency sponsorship

Additional Qualifications

• Excellent written and verbal communication skills.
• Working knowledge of Microsoft Office Product Suite.
• Comfortable and willing to learn new technology and software applications.
• Strong problem solving skills.
• 3+ years' direct supervisory experience.
• For positions supporting Medicare Part B, requires 2+ years of experience in Medicare Part B.

Preferred Qualifications

• CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures

Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.

Potential pay for this position ranges from $81,000.00 - $138,000.00 based on experience and skills.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.  

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.