Job Overview:The Clinical Pharmacist Manager is responsible for leading the pharmacy team reviewing clinical coverage determinations and appeals in accordance with the criteria, policies and practices of SlateRx, LLC. The Clinical Pharmacist Manager is responsible for the day-to-day activities of clinical pharmacist team as they work to meet business unit objectives and expectations regarding efficiency, accuracy, timeliness, privacy maintenance and quality decision making.
Responsibilities:As a Clinical Pharmacist Manager, your key responsibilities will include:
- Lead the Clinical Pharmacist team, inclusive of hiring, coaching, and evaluating staff.
- Support and advise clinical pharmacists with member, client, and software issues.
- Handle escalated clinical issues.
- Respond to routine inquiries and correspondence regarding coverage determinations and appeals from internal stakeholders.
- Oversee the Clinical Pharmacist coverage determination and appeals process from start to finish to ensure queues are being handled efficiently and requests are completed timely.
- Monitor and update daily productivity reports.
- Develop Clinical Pharmacist monthly schedules to ensure appropriate coverage for timely completion of coverage determinations and appeals.
- Report accomplishments, infractions, and overall productivity to upper management.
- Train and update staff on changing procedures and PA software system.
- Conduct performance evaluations.
- Promote and foster a professional, positive, dynamic team environment through exemplary leadership.
- Mentor staff to improve skillset and career development.
- Advise on employee promotions, transfers and dismissals.
- Collaborate with cross-functional team leads to streamline and drive efficiencies in the coverage determination process.
- Performs miscellaneous job-related duties as assigned.
Qualifications:To excel in this role, you should possess the following qualifications:
- Knowledge in the healthcare, insurance or PBM industry.
- Experience working in a Prior Authorization unit.
- Knowledge of pharmacy benefit management, CDAG operational processes, and benefit plan design.
- Proven experience in managing and leading a team.
- Pharmaceutical and medical knowledge necessary to effectively discuss drug therapy issues with physicians and pharmacists.
- Working knowledge of applicable state and federal pharmacy regulations.
- Computer and typing proficiency.
- Ability to adapt to a dynamic and fast-paced environment.
- Ability to work with peers in a team effort.
- A well-organized and self-directed individual who is able to work with minimal amount of supervision.
- Capability to efficiently complete tasks in a demanding environment.
Education:Bachelor of Pharmacy Degree or Pharm.D. required.
License Requirement:Current, valid and unrestricted Pharmacist License in at least one state of the United States required.
Job Benefits:Health, Dental, Vision, Life, 401k, Paid Time Off.
Location:Remote
