Job Summary
Responsible for overall strategy, planning, development, implementation, and supervision of Enterprise Pharmacy managed care pharmacy services for all lines of business. Possesses and maintains the oversight of the managed care pharmacy staff and leadership teams, functioning as a leader and facilitator in a team-based environment.Clearly and effectively articulates in a timely fashionthe mission, goals,directions, critical issues,and values to the employees who work within the respective area of responsibility. Oversees and coordinates the operational and clinical programs of the Enterprise Pharmacy managed care pharmacy services and, in collaboration with Chief Pharmacy Officer (CPO), sets the strategic vision for Geisinger’s managed care pharmacy pillar.
Job Duties
- Provide operationalandclinical oversightandaccountabilityforallmanaged carepharmacyservices, includinghuman resources, financial planning and ongoing growth and development. This includes but is not limited to formulary management, clinical policy development, utilization management operations and pharmacy benefit configuration.
- Serves as department liaison and program steward across the organization, with outside constituents, and with strategic partnersincluding pharmaceuticalindustrypartners,pharmacy benefit managers (PBM),legislativegroups,otherhealthsystems ,schools of pharmacy,andprofessionalpharmacyorganizations.
- Overseethedevelopment,revision,andauditing ofapplicable policiesandoperationalprocedures,compliancewith federal and state regulatory requirements (CMS, DHS, etc.) and other standards of practice (NCQA, ACA, etc.).
- Leads andchairs system-level initiatives and workgroups upon request from executive and system leadership. Provides direction and guidanceforthedevelopmentandimplementationofoptimumstandards ofmanagedcarepharmacyservices, pharmacy benefit management services, medication therapy disease management, and medication management processes.
- Develops,communicates,andparticipatesinresearchtoenhancetheimpactofclinicalpharmacy andinnovativecare delivery models providing optimal customized care for Geisinger’s patients.
- Ensures collaborationwithother departmentsregardingissues relatedtomanaged carepharmacypracticesand all aspects of medicationmanagement for areas of responsibility
- Serves in oversight capacity in the development and implementation of all strategic, tactical, and business plansto the Director, Assistant Directors andmedicaldirectors tocoordinatepharmaceuticalcareformembers
- EffectivelyengagesseniorHealthPlanandClinical Enterpriseexecutivesinsupportofdailypharmacy operations, implementation, and prioritization of initiatives. ServesasSecretaryontheHealthPlanPharmacy andTherapeuticsCommittee.
- Providesbothclinicalandoperationalguidance andoversightfortheenhancementanddevelopmentofneworexisting managedcarepharmacyservicesandpracticemodels.
- Closely collaborateswith the Geisinger Health Plan and our KACO partners on system-wide and multidisciplinary initiatives in support of an effectivevalue-basedcarepracticemodel.Exploresmutually beneficialcollaborationsoutside ofsystem,including thosewith schools of pharmacy, private funders, and research grantees Accountable for maintaining standards, clinical activities, operational activities and performance measurement tools that meet clinical, operational, and market needs in the areas of clinical practice, operational efficiency, quality, and patient satisfaction.
- Accountable for maintaining and communicating standards, clinicalactivities,operationalactivitiesandperformancemeasurement toolsthatmeetclinical,operational,andmarketneeds in theareasofclinicalpractice, operationalefficiency,pharmaceuticalprocurement,medicationutilization,quality,andpatientsatisfaction.
- Assistswiththedevelopment,implementation,andforecastedfinancialoutcomes,andprovidesinputintobusiness plansand financial pro-forma in concert with the Chief Pharmacy Officer.
- Responsibleforensuringthedevelopmentandimplementationofoperationalcontingencyplansinconcert withtheChief Pharmacy Officer as financial conditions warrant. Proactivelyassessesandanalyzesrisks/issuesthatmaycompromisesuccessofoperationsorinitiativesanddevelopsplans to remove or mitigate them.
- Utilizesfinancialorbenchmarkingreports tomonitorallrevenueandexpenseimpactingactivityrelatedtoallareas of oversight , proactively acts on this information and reports summary information to the CPO.
- CollaborateswithHumanResourcesonrecruitmentandretentionactivitiesregardingpharmacystaff.Providesoversight and guidance for human resource management including development and disciplinary actions.Collaborateswithpharmacyleadershipteamtoensure thatthepharmacy staffutilizetheir highestskillcapacity tofacilitate innovations in care delivery across the care continuum for all aspects related to pharmacy services.
- Providesadministrative,operational,andclinicaloversight andguidanceforsystem-widepharmacy educationalprograms and processes including pharmacy residency and student programs, collaborative practice,credentialingandcontinuingprofessionaldevelopmentofstaff.
- Coordinatesandanalyzes industry,enterpriseandmemberspecific dataandintelligencetoperformneeds assessmentsand solution development for solutions that integrate care, improve clinical quality, and drive affordability, leveraging enterprise pharmacy assets.
- Developsolutionsthatalignwithkeypillars, includingaffordability,access, quality,memberexperience,integrated healthcare, value-based alignment and health equity.
- UtilizesbroadunderstandingofmanagedcareandPBMknowledgetodevelop,and/or implementstrategiesandprogramsto mitigate cost trend and improve health outcomes. Manage relationship and provide oversight of key vendor partners responsible for any outsourced programs.
Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position.
Education
Master's Degree- (Required)
Experience
Minimum of 7 years-Managerial/Supervisory (Required), Minimum of 10 years-Related work experience (Required)
Certification(s) and License(s)
Licensed Pharmacist (Pennsylvania) - State of Pennsylvania
About Geisinger
Founded more than 100 years ago by Abigail Geisinger, the system now includes ten hospital campuses, a 550,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. With nearly 24,000 employees and more than 1,700 employed physicians, Geisinger boosts its hometown economies in Pennsylvania by billions of dollars annually. Learn more at geisinger.org( opens in new window) or connect with us on Facebook( opens in new window), Instagram( opens in new window), LinkedIn( opens in new window) and Twitter( opens in new window).
Equal Opportunity Employer
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.
Our Vision & Values
Everything we do is about making better health easier for our patients, our members, our students, our Geisinger family and our communities.
KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
EXCELLENCE: We treasure colleagues who humbly strive for excellence.
LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
SAFETY: We provide a safe environment for our patients and members and the Geisinger family.
Our Benefits
We offer healthcare benefits for full time and part time positions from day one, including vision, dental and prescription coverage.