Dir, Clinical Operations

Magellan Health Services   •  

Middletown, RI

Industry: Healthcare

  •  

5 - 7 years

Posted 88 days ago

This job is no longer available.

  • Works closely with teams to ensure consistent delivery of approved programs to their client. Ensures operations are standardized at the fullest extent possible. Provides overall project coordination for contract clinical and operational functions.
  • Oversees and coordinates implementation of new clinical programs and serves as liaison between the Clinical program managers and Clinical Services Center (CSC) outreach team. Assists in modifying implementation approaches within operational execution of the clinical program. Develops strong relationships and contacts within the company that support the achievement of efficient and effective clinical program outcomes.
  • Through CSC managers, communicates frequently with Clinical program managers to report program progress, establish priorities and maintain positive program outreach results. Responds to requests for information. Assesses, investigates and resolves difficult issues to achieve program objectives.
  • Coordinates outreach with physicians and prescribers identified as needing consultation to provide coaching on prescriptions and prescribing practices that have been identified as outliers. Responsible for oversight of all program outreach and delivery.
  • Collaborates with Clinical program managers on development and refinement of consultation scripting used for program outreach.
  • Contributes to the success of the operations of the pharmacy program by assisting with management of both written and verbal communications to physicians and prescribers and maintenance of the edits and data elements that support the edits.
  • Contributes to program execution and delivery by using staff productivity metrics and continuous quality improvement processes within the CSC. Identify improvement opportunities by on-going consultation and collaboration with CSC managers and Clinical program managers.
  • Directs, develops and managers CSC managers and all pharmacist, pharmacy technician, registered nurse, and customer care associates within the CSC. Develops, implements and monitors clinical program delivery working with the clinical team and external customers to execute strategic clinical vision. Supports drug utilization review (DUR) efforts by reviewing physician prescribing patterns and consulting with physicians regarding these patterns using evidence-based best practices.

Minimum Qualifications

Education

PharmD: Pharmacy (Required)

License and Certifications - Required

PharmD - Doctor Of Pharmacy, State Licensure - Pharmacy

License and Certifications - Preferred

Other Job Requirements

Responsibilities

  • 5+ years of experience in clinical operations, quality, network, pharmacy or project management.
  • Experience in specialty and medical management is a plus, as is behavioral health/substance abuse pharmaceutical service experience.
  • Knowledge of current research related to behavioral health medications, specialty and medical management, and clinical quality improvement initiatives (e.g. STAR, HEDIS).
  • Ability to receive assignments in the form of high level objectives and independently establish detailed goals to meet objectives.
  • Strong interpersonal skills; excellent verbal and written communication skills.
  • Ability to function independently and as a team player.
  • Good organization and time management, with the ability to manage multiple tasks and be self motivated.
  • Proven ability to plan, organize, schedule, direct, control and monitor project activities.
  • Well-developed interpersonal skills.
  • Ability to interact at a high level with external contacts.
  • Working knowledge of Microsoft Office Product Suite.

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