Clinical Program Manager
Pharmpix Guaynabo, PR
- Expired: over a month ago. Applications are no longer accepted.
This is your chance to unleash your full potential!
PharmPix, is currently seeking for qualified Clinical Program Manager candidate to join our team. We are looking for successful people like you. Join the fastest growing Pharmacy Benefit Management (PBM) company in its category and take your professional career to the next level. PharmPix has become a leading provider of pharmacy benefit solutions and services in the continental United States and the territories.
Our work philosophy is based on commitment, dedication and loyalty. We take care of our employees, just as we ensure the welfare of our clients and partners. If you are creative, service oriented, resourceful and visionary, we would like to hear from you.
The Clinical Programs Manager reports to the CPO/President and will be responsible to oversight all clinical programs.
Essential Roles and Responsibilities
- Supervision of the P&T Committee Pharmacist. Through her team, Support to the P&T Committee Pharmacist for the preparation and update of Pre-Authorization evaluation forms, information and documentation list for Call Center and the update of the PA drug list and Specialty List.
- Prepare education to members, clients and pharmacies like for example medication recalls
- Attend P&T Committee Meetings.
- Support all Quality Management Program initiatives.
- Formulate and review annually Policies and Procedures (including SOP- Standard Operating Procedures) regarding Clinical Programs.
- Lead the Clinical Monthly Meetings.
- Lead the relationship with Universities and pharmacy students.
- Ensure compliance with URAC Accreditation of Clinical Quality Programs.
- Supervise all clinical programs compliance with procedures established.
- Help the account management and sales team in the sale or upsale of PPX clinical programs.
- Maintain professional affiliations and enhances professional development to keep current in the latest healthcare trends and developments.
- Assistance in the presentations to the client of the FWA reports.
- Supervise the P&T Committee pharmacists’ performance of the periodic (every year) revision of PA criteria
- Interpret data, analyze results using statistical techniques and provide ongoing reports and recommendations to management.
- Support Clinical, Formulary and Account departments providing via his/her contribution to the clinical aspects of the Utilization Management (UM) review process
- Provide clinical consulting services through analyzing drug utilization patterns and trends for Pharmacy Benefit Management (PBM) clients
- Apply basic pharmacoeconomic analytic principles to clinical and financial data to inform value-based decisions
- Remains current and knowledgeable about new initiatives, activities, opportunities, tools, and techniques through research, training, and continuous education.
- Other projects and duties as assigned.
Professional Experience and Skills Requirements:
- Bachelor Degree in Pharmacy or Pharm D, preferred
- AMCP Managed Care Certification within first six months of employment.
- Unrestricted Puerto Rico Board of Pharmacy License in Good Standing
- Active membership in the “Colegio de Farmacéuticos de Puerto Rico”.
- One (1) year post-graduate experience in the healthcare industry preferred in patient care.
- A thorough understanding of the managed care industries from the perspective of a PBM as well as providers of care.
- A thorough knowledge of the Puerto Rico managed care market
- Knowledge of the purposes, organization and policies of the community’s health systems sufficient to interact with other health care providers.
- Knowledge of federal and the Commonwealth of Puerto Rico health care delivery and pharmacy regulations/regulatory agencies.
- Knowledge of Microsoft applications.
- Fully bilingual English and Spanish.
- A thorough comprehension of Medicare Part D rules and regulations.
- Knowledge of the rules and regulations promulgated by the US Congress related to pharmacy benefits, specially the new pharmacy benefits available to Medicare beneficiaries under the Medicare Modernization Act of 2003.
- Knowledge of financial aspects of managed care contracts, financial data and compliance
- A demonstrated ability to establish and maintain quality control standards
- Strong problem analysis and decision-making skills.
- Strong analytical skills.
PharmPix is an Equal Employment Opportunity Employer Minorities / Females / Disable / Veterans
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