Job Description

The ideal candidate will have Pharmacy Operations Manager / Supervisor experience in a health plan / PBM / managed care environment.

 

The Pharmacy Operations Manager is accountable for delivering the expected operational results for prior authorization and pharmacy help desk functions across all Health Choice product lines.  These results include meeting specific targets and goals related to people, process, and supporting data / technology.  The Operations Manager is accountable for the continuous assessment of the prior authorization and help desk functions, identifying improvement opportunities, assessing risks, and communicating observations, recommendations, and results to management.  The Operations Manager is also accountable for appropriately integrating the prior authorization and help desk functions with other utilization management functions including those delegated to vendors to be compliant.

 

The Pharmacy Operations Manager assists the Director and management in developing, implementing and evaluating departmental policies, desktops, processes, and procedures that ensure efficiency, effectiveness, quality, and consistency.

 

Develops and leads a high performance team.

 

Acts as a liaison to Legal, Compliance, and Quality departments on those issues that have both legal risk and compliance aspects and coordinates with the Accreditation Manager and other pharmacy staff on URAC audits, AHCCCS audits, UDOH audits, CMS audits as well as being responsible for all corrective actions in assigned area.

 

Health Choice exists to improve the health and well-being of the individuals we serve through our health plans, integrated delivery systems and managed care solutions. We strive to recruit and retain only the finest health care professionals with the highest levels of integrity, compassion and competency. If you are driven by your own personal commitment to these values and desire to work in a team-focused, collaborative and supportive environment - while still being valued for your individual strengths - Health Choice is the place for you.

Equal Opportunity Employer Minorities/Women/Veterans/Disabled



Qualifications

Qualifications:

High School Diploma / GED

Arizona Certified Pharmacy Tech required

Arizona Pharmacy Tech license required

Bachelor's degree preferred

At least three (3) years' management experience in a pharmacy setting

Previous Medicaid / Medicare experience preferred

Prior authorization / utilization review experience preferred

Call center experience preferred

Knowledge of medications, medical terminology and Medicare / Medicaid regulations and guidelines

Ability to manage and lead others

Ability to think proactively, analytically, and make decisions

Ability to manage a large workload

Application Instructions

To apply directly to Steward Health Care, please click the link below. Another window will open and allow you to apply directly online.

Apply Online