AGATE RESOURCES, INC.

POSITION DESCRIPTION

POSITION TITLE:  Pharmacist Manager

POSITION SUMMARY:  Provide ongoing management of pharmacy services for Trillium, Lipa and affiliated companies

PRIMARY RESPONSIBILITIES & DUTIES:

1.      Supervision of Pharmacists, Pharmacy Technicians, Benefit Specialists and others as assigned.

2.       Act as resource regarding clinical criteria/questions and complex requests

3.      Work with Medical Directors to provide benefits within State and Federal guidelines

4.      Support medical management nursing staff in making Part B medication determinations

5.      Review prior-authorization requests/coverage determinations

6.      Assist with clinical aspects of grievances and appeals

7.      Act as primary management liaison with Pharmacy Benefits Manager (PBM)

8.      Oversight and monitoring of Part D functions as mandated by CMS

9.      Contribute clinical expertise to and work with staff to prepare materials for the Pharmacy & Therapeutics Committee (P&T)

RELATIONSHIPS & WORK TEAM RESPONSIBILITIES:

Reports To:  Senior Medical Director

Internal:  Work closely with Medical Directors, Clinical Pharmacists, P & T Committee members, members of Medical Management department, members of Operations department, and subsidiary companies. 

External:  Communicate with Pharmacy Benefit Manager, physician offices, pharmacies, members and advocates

JOB REQUIREMENTS:

Education:

• Pharm D preferred; Bachelor’s degree in Pharmacy will be considered with relevant experience.  Must hold current Pharmacist license

Experience:

• Knowledge of Medicare Part D pharmacy benefits management, rules and monitoring requirements.
• Knowledge of Oregon Health Plan benefits, regulations, and authorization guidelines preferred
• Experience in management/supervisory roles
• Experience in managed care preferred

Skills:

• Experience reviewing and interpreting medical information
• Excellent drug knowledge and ability to know where to find clinical answers
• Excellent customer service skills, and enjoys working and interacting with others, including medical professionals, business professionals, and members
• Strong verbal and written communication skills
• Proficiency in Microsoft Excel and Word
• Ability to learn and train on new technologies
• Ability to work both independently and collaboratively as a member of a team
• Be pro-active in handling clinical and coverage situations/issues
• Demonstrated ability with drug formularies and UM programs
• Excellent organizational skills

• Ability to translate broad strategies into specific objectives and action plans
• Ability to interpret State and Federal regulations applicable to health plan pharmacy benefits

• Ability to identify and communicate  trends