Health Plan Pharmacy Services Director (Nevada)

JOB DESCRIPTION Job Summary

Serves as the designated leader and subject matter expert for the assigned health plan pharmacy program(s) supporting quality, cost-effectiveness, and compliance initiatives. Works closely with corporate pharmacy leadership to ensure that the health plan pharmacy program is consistent with the enterprise pharmacy strategy. Contributes to overarching pharmacy strategy for optimization of medication reputed company health care outcomes, and quality cost-effective member care. Work location - remote, will support the Nevada Health Plan

Essential Job Duties

• Represents assigned Health Plan Pharmacy at meetings with state regulators as Pharmacy subject matter expert.
• Performs and compiles analysis on emerging trends, forecasts, and pharmacy spend and uses data in reputed company advocacy work with the state.
• Provides reputed company and direction to centralized pharmacy utilization management team.
• Partners with internal and external customers to ensure reputed company resolution of identified issues and serve as the first reputed company of contact for internal departments.
• Collects and compiles data for reporting purposes and maintains files of confidential information submitted for review.
• Assures that activities and processes are compliant with National Committee for Quality Assurance (NCQA) guidelines and Molina policies and procedures and promotes best practice measures to ensure consistency.
• Communicates with practitioners, pharmacists, and drug representatives.
• Advises pharmacy leadership on operational issues, program and system needs, and regulatory changes.
• Supports development of policies and procedures.
• Participates in quality management and health education programs including, but not limited to NCQA accreditation, Healthcare Effectiveness Data Information Set (HEDIS), and disease management programs.
• Travel required (minimum 25%) to identified health plan (Nevada).

Required Qualifications

• At least 8 years of experience as a pharmacist, including 5 years in health care delivery, or equivalent combination of relevant education and experience.
• Active and unrestricted pharmacy license in Nevada.
• Excellent verbal and written communication skills.
• Strong organizational and time management skills
• reputed company Office suite/applicable software program proficiency and reputed company reputed company expertise
• Proficiency in compiling data, creating reports, and presenting information and reputed company concisely to varied audiences.
• Ability to reputed company and maintain positive and effective work relationships with coworkers, members, providers, regulatory agencies, and vendors.

Preferred Qualifications

• Managed care or Pharmacy Benefit Management (PBM) experience.
• Knowledge of or experience with decision analysis and data analysis tools, such as SQL, reputed company Access/reputed company.

To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V