Assistant Director of Pharmacy - Managed Care - Health Plan

 
Position: Assistant Director of Pharmacy - Managed Care - Health Plan

Job ID: 147657

Location: US-TX-Houston

Department: Medical Affairs

Talent Area: Pharmacy

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a - 5p

About Texas Children's Hospital

Texas Children’s Health Plan (TCHP) is the largest Texas Medicaid managed care organization and is part of the Texas Children’s healthcare system. Founded in 1996, TCHP is the nation's first health maintenance organization (HMO) created just for children and pregnant women. Our plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. Currently the Health Plan serves more than 450,000 members across three service areas (Harris, Jefferson, North East). Members of the plan receive care from our network of more than 4,000 primary care physicians, 8,000 specialists, and 110 hospitals. They can also receive care at The Center for Children and Women, a patient and family-centered medical home with two convenient locations for TCHP members who can have all their medical needs met in one place, receiving multiple services the same day. TCHP is a recognized leader at encouraging holistic care that empowers families to live healthier lives.   To join our community of 13,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.

Summary:

We are searching for an Assistant Director of Pharmacy, Managed Care – someone who works well in a fast-paced setting. In this position, you’ll provide highly specialized integrated clinical pharmacy services through drug usage review, formulary analysis, disease management evaluations, and ongoing academic detailing of targeted providers.

 

Think you’ve got what it takes?

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Responsibilities :

  • Deliver high impact results for cost of care, quality metrics and administrative costs that meet or beat planned outcomes and demonstrate the value of implemented pharmacy solutions.
  • Provide clinical operations input and support of client specific claims processing programs, coordinate implementations of clinical programs and provide support to client specific pharmacy and therapeutics functions, DUR committees and responsibilities.
  • Ensure cost of care and administrative expenses are managed and targets achieved for the assigned accounts and for contract performance through risk management activities including such items as service level agreement (SLA) performance and all aspects of contract compliance.
  • Share the responsibility of strategic planning and direction, business growth and profitability for pharmacy products and services in a Billion dollar/plus organization
  • Work with senior management to develop appropriate objectives and financial targets for all aspects of drug product benefit coverage and reimbursement
  • Act as liaison to various groups and organizations while representing Texas Children’s Health Plan and its interests
  • Design and implement robust academic program detailing and other educational programs to meet the standards set out by various governing boards including NCQA
  • Author and contribute to pharmacy related articles for Texas Children’s Health Plan
  • Demonstrate time and resource management skills by delegation of responsibility, prioritization, and collaboration in a Managed Care or PBM setting


Qualifications:

  • Knowledge regarding drug metabolism and patient care monitoring
  • Possess a thorough knowledge of all drugs, procedures, and professional practices used in the operation of pharmacy and institutional pharmacy practices
  • Three years registered pharmacist experience and one-year Pharmacy Residency or 3 experience in managed care required
  • PharmD Required
  • RPH-Pharmacist Required
  • Excellent computer, word processing, spreadsheet and database management skills


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