Director, Clinical Pharmacy

Job Responsibilities

• Lead, direct, and oversee all clinical aspects of current and future pharmacy benefit programs, ensuring appropriate policies, procedures and resources are in place and aligned with all applicable regulations and requirements
• Directs and manages staff responsible for the development and implementation of new and revised clinical pharmacy services across pharmacy and medical management; ensures strategic alignment of clinical services across the enterprise where appropriate
• Directs and oversees all aspects of staff and any vendor(s) performing case review for the pharmacy care management programs, member appeals, grievances and complaints all within the established time periods
• Leads the management of appropriate drug utilization through formulary creation, clinical criteria development, and utilization management activities, including prior authorization and appeals

Job Qualifications

Education

• Doctor of Pharmacy (PharmD) Degree

Experience

• 7 years - Senior leadership-level experience and documented record of success in management of multi-disciplinary pharmacy operations required

SkillsCertifications

• Competency in compendia navigation and research
• Outstanding negotiation, presentation, and facilitation skills
• Excellent oral and written communication skills
• Adaptive to high pace and changing environment
• Proven effective supervisory and leadership traits to manage and direct others
• Knowledge of medical and pharmacy products
• Basic understanding of provider reimbursement methodologies, including fee schedule pricing, DRG reimbursement, bundled outpatient hospital payment mechanisms, capitation, risk sharing arrangements and other payment methodologies
• Demonstrated consumer healthcare market understanding/knowledge required

License

• Licensed in Tennessee to practice Pharmacy, or eligible for licensure in the state of Tennessee to practice Pharmacy

Number of Openings Available

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