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Manager Pharmacy Services

Company: Blue Cross Blue Shield of Rhode Island
Location: Providence
Posted on: January 16, 2020

Job Description:


Job Description
Manage daily operations of pharmacy benefit programs; act as an expert on clinical pharmacy issues. Oversee the development and maintenance of cost-effective pharmacy management programs. Respond to internal questions concerning plan coverage and policies for specific pharmaceuticals, research appropriateness of drug therapies, and provide feedback on state regulatory and legislative issue. Manage the development, implementation, and maintenance of departmental policies, procedures and programs.

ESSENTIAL JOB FUNCTIONS:

  • Provide direction and technical guidance to staff. Set goals, review and evaluate work, and prepare performance reviews.
  • Manage daily operations of pharmacy benefit programs; oversee the development and maintenance of cost-effective pharmacy programs that increase medication compliance and ensure appropriate member care.
  • Act as an expert on clinical pharmacy issues within the organization and to external companies including the company Pharmacy Benefit Manager. Respond to clinical questions regarding prescription medications including those utilized by members.
  • Collaborate with internal departments and physicians to improve prescription and clinical practices to ensure high quality, cost-effective care.
  • Review prescriptions issued by physician or other authorized prescriber to ensure appropriateness of therapy and compliance with the formulary.
  • Assist in the development of physician educational interventions.
  • Analyze prescription data, identify areas for improvement, and provide recommendations to physicians.
  • Educate internal departments on plan policies, benefits, and any other administrative matters related to pharmacy.
  • Perform other duties as assigned.
    QUALIFICATIONS:
    Minimum Education and Experience:
    • Bachelor's degree in Pharmacy or related field; or an equivalent combination of education and experience.
    • Current pharmacist license in the state of Rhode Island.
    • Five or more years clinical pharmacy experience.
    • Three to five years management experience or experience leading a team.
    • Managed care experience and specific knowledge and training in prescription drugs, pharmacy benefits, utilization review, cost containment strategies, and emerging technology.
      Required Knowledge, Skills, and/or Abilities:
      • Knowledge of formularies, rebate contracts, and pharmacy benefit design.
      • Knowledge of cost containment and utilization review strategies.
      • Knowledge of state and federal laws as applicable to the health insurance industry.
      • Knowledge of health care plans and benefits.
      • Ability to coach and motivate to maximize performance.
      • Ability to effectively communicate goals and business objectives to employees.
      • Strong and effective decision-making skills.
      • Strong organization and time management skills.
      • Proficiency with Microsoft Suite of products (i.e., Word, Excel, PPT, etc.).
      • Ability to effectively interact with all levels of the organization.
      • Ability to effectively delegate work and manage project tasks.
      • Excellent verbal and written communication skills, with ability to convey complex or technical information in an effective manner.


        At Blue Cross & Blue Shield of Rhode Island (BCBSRI), diversity and inclusion are central to our core values and strengthen our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity, affirmative action employer. We provide equal opportunities without regard to race, color, religion, age, national origin or ancestry, disability, veteran status, sexual orientation, genetic information, sex, gender identity or expression, and any other personal attributes protected by federal, state, or local law. For more information about our commitment to diversity and inclusion, please see our Diversity Report at bcbsri.com/diversityreport .

        The law requires an employer to post notices describing the Federal laws prohibiting job discrimination based on race, color, sex, national origin, religion, age, equal pay, disability, veteran status, sexual orientation, and genetic information and gender identity or expression. Please visit http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf to view the "EEO is the Law" poster.



        BCBSRI is committed to working with and providing reasonable accommodation to individuals with disabilities. If, because of a disability, you need a reasonable accommodation for any part of our application process, please contact us at (see application details) for assistance.

        During the application process, please allow a minimum of five business days before you contact our office to inquire about the status of your application. If you have any questions regarding your application or during the process, please contact Human Resources by phone at (see application details) or by email at (see application details) .

        Southern New England, Boston, MA, Hartford, CT, Health Data Analyst, RI Health Insurer, Healthcare, Wellness, Provider, Network, Rhode Island, RI, Pharmacist, Pharmacists, Pharmacy, Dosage, Dispensary, Medication, Pharmaceutical, Pharmacotherapy, Plan, Insurance

Keywords: Blue Cross Blue Shield of Rhode Island, Providence , Manager Pharmacy Services, Executive , Providence, Rhode Island

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