Reporting to the Director of Pharmacy Services, the Manager of Pharmacy Operations is primarily responsible for oversight of the daily operations of the Pharmacy Services department, including pharmacy utilization management (UM) activities, review of all pharmacy prior authorization requests, oversight of the UM activities of the Pharmacy Operations support staff, and maintenance of existing pharmacy UM programs. In addition, the Manager will assist with pharmacy utilization management and clinical policy implementation, developing training for the pharmacy operations staff, and performing quality assurance analyses ensuring compliance with regulatory and accreditation requirements.

Key Functions/Responsibilities:

• Oversee daily operations of Pharmacy Services including the Pharmacy UM Program, prior authorization activities, customer service metrics and responding to internal and external inquiries. • Ensure policies and procedures meet regulatory and accreditation requirements • Assist with implementing formulary management decisions and clinical policies • Responsible for pharmacy operations reporting and monitoring performance metrics, identifying opportunities for improvement • Ensure that pharmacy services meet internal and external standards for turnaround times. • Conduct quality assurance reviews for pharmacy prior authorization decisions for consistency with covered benefits, clinical policies, medical necessity, and inter-rator reliability. • Ensure that pharmacy prior authorization requests and decisions are properly documented and evaluated. • Implement policies and procedures to meet regulatory mandates and requirements • Hire, orient and provide supervision, performance evaluation and professional development to all Pharmacy Operations staff. • Responsible for training and development of Pharmacy Operations staff • Partner with clinical and non-clinical teams for staff trainings, facilitation of meetings and other ad hoc presentations. • Participate in the development and design of drug utilization programs and new clinical program opportunities • Develop initiatives that align with annual corporate and departmental goals related to the administration of the pharmacy benefit in a cost-effective, quality-driven pathway • Other activities as necessary to support organizational initiatives. • Regular and reliable attendance is an essential function of the position. • Is knowledgeable with the functions of formulary management and is able to cross cover for the Clinical Pharmacy team when necessary. • Supervises pharmacy operations staff

Qualifications:

Education:

• Bachelor of Science in Pharmacy. • Current unrestricted licensure as a pharmacist in the Commonwealth of Massachusetts. • Doctor of Pharmacy and/or Residency training and Board of Pharmaceutical Specialties (BPS) certification in Pharmacotherapy preferred

Experience:

• 5 years of clinical experience required

Preferred/Desirable:

• 2+ years of prior managed care experience • Pharmacy & Therapeutics Committee experience • Previous management/supervisory experience

Competencies, Skills, and Attributes:

• Extensive knowledge of drug products, medical therapeutics, pharmacokinetics, and disease states. • Strong oral and written communication skills; ability to interact within all levels of the organization as well as with external contacts. • Demonstrated strong organization and time management skills. • Able to work in a fast paced environment; ability to multi-task. • Experience with standard Microsoft Office applications, particularly MS Outlook and MS Word, and other data entry processing applications. • Strong analytical and clinical problem solving skills. • Occasional travel (<5%) may be required.

Required Skills Required Experience

KNOWLEDGE, SKILLS, & ABILITIES:

• Ability to learn Operations Division policies, procedures, Agency regulations and the Union contract.
• Considerable knowledge of the Paratransit Division fare structure and policies.
• Considerable knowledge of the street geography of metropolitan St. Louis.
• Ability to evaluate the work of subordinates.
• Ability to operate an automobile in a safe and courteous manner.
• Ability to communicate effectively, both orally and in writing.
• Ability to evaluate a problem, formulate corrective response, and implement a plan of action to achieve desired results.
• Ability to make decisions. Possess effective customer service skills.
• Ability to work in emergency situations. Computer skills in word processing, spreadsheets, and database management are necessary to successfully perform computer related job functions.