Experience Inc. Jobs

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

Manager, Clinical Pharmacists

Job Description Summary

Oversees day-to-day operations of a team of call-center pharmacists to ensure department objectives and contractual service levels are met. Ensures adherence to standard operating procedures. Triages client and internal requests to resource assignment. Responsible for staff and schedules.

Job Description

• Manages the prior authorization program and monitors adherence to client's established clinical criteria.

• Manages appeal and physician resources, follows contractual obligations, maintains National Committee for Quality Assurance (NCQA) accreditation, maintains Utilization Review Accreditation Commission (URAC) accreditation, and follows State and Federal regulations.

• Manages staff resources, resource allocation, and staff schedules to ensure adequate work coverage. Regularly communicates necessary information including personnel relations activity including employment, termination, performance reviews, salary reviews and disciplinary actions.

• Implements quality assurance reviews consistent with corporate QA programs.

• Ensures annual and corporate training requirements are complete.

• Manages and handles new client implementations, program additions, and new client bid requests.

• Implements QA process and inter-rater reliability testing to staff.

• Mediates client escalated concerns, issues, and complaints.

• Assists account team executives with client issues.

• Identifies gaps which include IT systems, phones, edits and operational procedures, recommends modifications and improvements.

• Provides end-user input during meetings to strengthen systems and unify internal clinical criteria.

• Analyzes daily, weekly, and monthly statistical reports and makes appropriate recommendations and forecasts regarding call volume and staff scheduling.

• Provides input into the departmental budget.

• Potentially makes outbound or takes inbound telephone calls to assist in various aspects of patient care and/or product distribution to/from practitioners, members, and pharmacies.

• Takes calls including, but not limited to, comprehensive medication reviews, targeted medication reviews, call to practitioners about product awareness, and prior authorizations.

Responsibilities

• Current unrestricted state license required.

• Demonstrated customer service and analytical skills.

• Ability to use standard corporate software packages and corporate applications.

• 5-7 years' pharmacy experience required.

• 3-5 years' supervisory experience required.

• Previous experience in managed health care or Pharmacy Benefit Management environment preferred.

• Call center experience preferred.

Work Experience

Work Experience - Required:

Management/Leadership, Pharmacy

Work Experience - Preferred:

Education

Education - Required:

Bachelors - Pharmacy

Education - Preferred:

PharmD - Pharmacy

Certifications

Certifications - Required:

RPH - Registered Pharmacist - Pharmacy - Pharmacy

Certifications - Preferred:

PharmD - Doctor Of Pharmacy, State Licensure - Pharmacy - Pharmacy

Potential pay for this position ranges from $122,630.00 - $208,450.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/benefits) and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.

Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.

If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.