Job: Manager, Pharmacy Operations (HH Mgr, Pharmacy Ops M2)

Jobing Description

Description:
- Manager, Pharmacy Operations (HH Mgr, Pharmacy Ops M2) (1100715)

Job Description

Manager, Pharmacy Operations (HH Mgr, Pharmacy Ops M2)- 1100715

Description (We are proud to be an EEO/AA employer M/F/D/V.)

The Pharmacy Director for Healthways Hawaii directs the planning, organization, and management of Pharmacy Services though development and implementation of appropriate policies and practices for the $300MM spend on pharmacy. This role provides strategic direction for pharmacy issues across the population served by HMSA (BCBS of Hawaii) and managed by Healthways HI. This role reports to the Healthways HI Business Leader and will have a matrix reporting relationship to an executive at HMSA.

Responsibilities include:

* Responsible for managing all aspects of Healthways-Hawaii Pharmacy program, including medication use policy, benefit design, financial and clinical reporting, pharmacy network oversight, communications, quality initiatives, NCQA and HIPAA compliance, regulatory and contractual requirements and contract negotiations.
* Manage pharmaceutical costs and trends through analysis of industry, clinical and compliance laws and trends and provide leadership on cost containment opportunities.
* Effectively lead a team of pharmacy staff to insure efficiency, effectiveness and high job satisfaction.
* Provide innovative solutions which challenge the status quo.
* Oversee relationship with external PBM vendor (currently MEDCO) and other vendors to ensure contract compliance and delivery of services consistent with HMSA's standards of quality of care
* Lead vendor decision process, selection and contract negotiations with current and future vendors.
* Develops and manages department operational budget.

Qualifications

* Current unrestricted licensure as a pharmacist in the State of Hawaii or the ability to obtain unrestricted licensure within a reasonable period of time.
* Bachelor of Pharmacy with equivalent clinical and management background in a health plan or PBM as a minimum.
* 10+ years of pharmacy experience, including responsibility for formulary management, prior authorization and other clinical initiatives preferably in a health plan setting.
* Extensive knowledge of pharmacy workflow from prescription to claims submission and authorization request processing.
* Experience with interacting with health plan customers in benefit design and other activities which result in adding value through effective pharmacy management.
* Proven leader of people to accomplish desired goals.
* Experience with building and leading high functioning teams.
* Management experience preferred to include planning, execution, and monitoring department and organizational goals.
* Must be able to demonstrate independent decision-making.
* Possess strong analytic skills.
* Able to provide clear communication with the rest of the management team to ensure success of department and corporate goals and initiatives.
* Effective collaborative skills.
* Proven process improvement skills.
* Strong oral and written communication skills; ability to interact within all levels of the organization and its partners.
* A strong working knowledge of Microsoft Office products.

About Healthways:

For three decades, Healthways has been dedicated to improving the human condition. Each year, we learn more and do more for the millions of individuals who count on us to make a difference in their health and well-being. Healthways is a global provider of solutions that help employers, health plans and government agencies enhance business performance and reduce healthcare costs. Our mission is to create a healthier world, one person at a time.

Here at Healthways as we continue to make the world a healthier place, we have also created an environment where people choose 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."

Job
: Clinical / Nursing

Schedule
: Full-time

Shift
: Day Job

Primary Location
: HI-Kapolei

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