Pharmacy Director

POSTED: February 21, 2024 POSITION Pharmacy Director DEPARTMENT Pharmacy POSITION SUMMARY: This position coordinates, develops, and manages the pharmacy benefit division of the health plan and has overall accountability for the leadership and day-to-day operations.
This is accomplished through integration of activities with other departments, the Medical Director, the Pharmacy Benefit Manager, multidisciplinary members of the healthcare community, and regulatory agencies.
ESSENTIAL DUTIES AND RESPONSIBILITIES: 1.
Follows established Upper Peninsula Health Plan (UPHP) policies and procedures, objectives, safety standards, and sensitivity to confidential information.
2.
Ensures the effective and efficient provision of the pharmacy benefit and compliance with accrediting and regulatory requirements for Michigan Department of Health and Human Services (MDHHS) Medicaid and Centers for Medicare and Medicaid (CMS) Medicare lines of business.
3.
Prepares and oversees the department's budget such that it contributes to the cost-effective operations of the health plan and identifies opportunities for optimizing outcomes and resources of the organization.
4.
Acts as the primary liaison between the Pharmacy Benefit Manager (PBM) and the health plan for issues relating specifically to pharmacy assuring follow-up and documentation of action items and resolution.
5.
Coordinates Compliance, Auditing and Monitoring, and Oversight of Pharmacy Department functions with the Compliance Department.
6.
Develops, maintains, and monitors the health plan formularies in conjunction with Michigan Department of Health and Human Services (MDHHS), the Medical Director, Clinical Advisory Committee (CAC), and PBM.
7.
Coordinates the pharmacy program functions and activities including quality, utilization management (UM), and drug utilization review (DUR) collaborating interdepartmentally on activities, reporting, and analysis.
8.
Attends organizational, state, and federal required and as needed meetings to achieve objectives.
9.
Represents UPHP on the Pharmacy Directors workgroup of Michigan Association of Health Plans (MAHP).
10.
Coordinates activities, outreach, and collaboration with UPHP departments, delegated entities, outside agencies, and interested parties to carry out the goals and objectives of the health plan and meet contractual requirements.
11.
Enhances professional growth and development opportunities through participation in educational programs, current literature, and industry events as needed to foster the goals of the organization.
12.
Directs, supervises, and evaluates the work activities of pharmacy personnel.
13.
Develops and implements organizational policies and procedures for the department.
14.
Identifies and develops education and communication to providers, members, and health plan staff.
15.
Monitors industry trends and analyzes their effect on the health plan and communicates findings to Senior Management and the Management Committee.
16.
Maintains strict confidentiality of employee and organizational information in accordance with HIPAA and State privacy regulations.
17.
Assures required licensure and continuing education requirements are fulfilled on an annual basis.
18.
Maintains confidentiality of client data.
19.
Performs other related duties as assigned or requested.
POSITION QUALIFICATIONS: Education: Minimum: Bachelor’s degree in Pharmacy or Pharm.
D.
degree Licensed in the State of Michigan (current license without restrictions) Preferred: Master’s degree in Pharmacy, Health Care Administration, Business, or related field Experience: Minimum: Five (5) years of experience in the practice of pharmacy with some management/supervisory experience or two (2) years of UPHP pharmacist experience Preferred: Managed care or pharmacy benefit management company experience Clinical experience with focused patient and physician initiatives Medicare program experience regarding the Part D benefit Required Skills: Keyboarding proficiency and working knowledge of MS Office (Word, Excel, Access, PowerPoint) Effective verbal/written communication Excellent project management and organizational abilities Effective interpersonal communication and relationships The qualifications listed above are intended to represent the minimum skills and experience levels associated with performing the duties and responsibilities contained in this job description.
The qualifications should not be viewed as expressing absolute employment or promotional standards, but as general guidelines that should be considered along with other job-related selection or promotional criteria.
Physical Requirements: [This job requires the ability to perform the essential functions contained in the description.
These include, but are not limited to, the following requirements.
Reasonable accommodations may be made for otherwise qualified applicants unable to fulfill one or more of these requirements]: Ability to access departmental files Ability to enter and access information from a computer Ability to access all areas of the UPHP offices Moderate physical effort (lift/carry up to 25 pounds) Occasionally lifts supplies/equipment Occasional reaching, stooping, bending, kneeling, crouching Prolonged periods of sitting Occasional prolonged standing Manual dexterity and mobility Working Conditions: Works in office conditions, but occasional travel may be required Exposure to situations requiring exceptional interpersonal skills or periods of intense concentration Subject to many interruptions Occasionally subjected to irregular hours