ForgeApplyTry it free

ForgeApply · Job listing

Supervisor, Pharmacy - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)

Denver Health

Denver Health Medical Plan - 601 Broadway, Denver, US$131k – $216khybrid

Tailor your resume for this Denver Health job in about a minute.

ForgeApply tailors your resume and cover letter to this exact posting, then hands you a ready-to-submit application for Denver Health's site. Free trial, no card required.

Tailor my resume for this jobView original posting →

About this role

We are recruiting for a mission-driven Supervisor, Pharmacy - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement) to join our team! We're with you for life’s journey. At Denver Health, purpose isn’t just something we believe in—it’s something we live every day, for life’s journey.

Our Values Respect | Belonging | Accountability | Transparency

Department Managed Care Administration

* Must Live in Colorado

* This is a hybrid role located in Denver, Colorado with a requirement of being in the office 3 days per week.

Job Summary

The Supervisor, Managed Care Pharmacy, performs supervisor/leadership functions over the Denver Health Medical Plan (DHMP) / Managed Care Pharmacy clinical pharmacist and administrative staff. Applies critical thinking, clinical knowledge, evidence-based policies, procedures, guidelines, and competence to collaborate with the team to promote excellence and quality outcomes. Adheres to all Federal, State, and local laws, regulations, applicable health plan pharmacy services, and plan design. The primary role of the Supervisor is to provide operational and collaborative leadership for the Managed Care Pharmacy Department, with specific attention to quality of care, timely access, supervision, and mentorship for the pharmacy clinical staff and call team. An essential goal of this role is to maximize efficiency and positively impact the care provided to our members. The incumbent will be adept at collaborating with different teams within the organization. In collaboration with the Director, leads the development of specific departmental goals, standards, and objectives that directly support the strategic plan and vision of the organization. Promotes department sustainability and cost containment efforts to achieve budget. Identifies and implements strategies to monitor variance reports to enhance productivity while maintaining high-quality service. Implements programs that promote high motivation among team members by coaching, counseling, and setting goals for direct reports.

Essential Functions : • Supervises Pharmacist Clinical Specialist and Pharmacy Technician Call Center staff. Sets and communicates expectations to each employee and establishes job requirements and performance appraisal components. Regularly provides individual assessments to the Pharmacist Clinical Specialist and Pharmacy Technician Call Center staff to ensure timely feedback on performance expectations. (20%) • Performs timeliness monitoring, prior authorization, and call center auditing. Results are shared with staff, and corrective action plans will be implemented if deemed necessary. Presents annual reports of this data to the Medical Management Committee (MMC) and Quality Management Committee (QMC). Maintains assigned measures and documentation associated with National Committee for Quality Assurance (NCQA) accreditation. (10%) • Work with the clinical and operations staff of all vendors of pharmacy programs, including support to internal operational departments on implementing various programs. (10%) • Completes Prior Authorization requests clinical reviews and keeps current knowledge of system issues, processes, etc. Provides this feedback to the PBM and works with them to resolve issues. (10%) • Responsible for maintaining and updating Departmental Operating Procedures (DOPs) and Policy and Procedures (P&Ps) related to call center and prior authorization processes and oversight. (10%) • Handles Call Center escalations and works to resolve issues related to grievance and appeals, enrollment, etc. Maintains processes and communication between Managed Care Call Center teams and other relevant departments for efficiencies (10%) • Establishes and updates inbound and outbound call scripts. Creates standard workflows, identifies process gaps, and challenges self and others to develop and implement solutions. (10%) • Evaluate and identify opportunities for improved management of drug benefits through clinical research and analytics that improve medical/pharmacy cost savings and provide clinical quality initiatives. (10%) • Develop, implement, and manage pharmacy cost containment strategies, including high-risk, high-cost, and high-use medications, to determine the most appropriate medication use management strategy for identified medications. (10%)

Education : • Bachelor's degree B.Pharm required

Work Experience : • 1-3 years managerial/supervisory experience required or • 1-3 years pharmacy, managed care, and/or pharmaceutical industry experience required

Licenses : • PHA-Licensed Pharmacist - DORA - Department of Regulatory Agencies required

Knowledge, Skills and Abilities : • Excellent verbal and written communication skills with the ability to communicate and collaborate effectively with all internal stakeholders. • Strong interpersonal, consultation, organizational, tracking, and follow-up skills. • Data review and interpretation skills are preferred to identify and resolve drug-related problems and trends. • Ability to work as a team member. • Strong organizational skills and attention to detail. • Ability to instruct, direct, and evaluate employees- will be required to assume responsibility for daily PA operations. • Ability to work independently and with little supervision. • Prior experience and knowledge of process improvement practices • Proficiency with Epic, preferred but not required • Proficiency with MS Office required.

* Must Live in Colorado

* This is a hybrid role located in Denver, Colorado with a requirement of being in the office 3 days per week.

Shift Days (United States of America) Work Type Regular Salary $130,700.00 - $215,700.00 / yr

Benefits

At Denver Health, we take care of the people who take care of our community. Our benefits are built to support your life, your family, and your future — with generous paid time off, fully paid parental leave, exceptional retirement contributions, comprehensive health coverage, and nationall

Salary insight

The midpoint of this range ($173k) is about 33% above the median disclosed salary for Denver roles listed on ForgeApply ($130k across 843 jobs).

Based on live postings with disclosed pay on ForgeApply; refreshed daily. Not an estimate of this employer's offer.

Tailor your resume for this Denver Health role before you apply.

Tailor my resume for this job

Similar jobs

More like this: More jobs at Denver Health · Browse all jobs

Free ATS checker · How to Tailor Your Resume to a Job Description (Step by Step)