JOB PURPOSE:

The Manager Pharmacy Services leads the day-to-day clinical and operational functions of the Pharmacy Department for CenterLight and its subsidiaries. The role supervises pharmacy staff, promotes medication access and safe, effective, and cost-conscious medication use, and coordinates pharmacy activities across the Interdisciplinary Care Team (IDT), providers, pharmacies, the Pharmacy Benefit Manager (PBM). The Manager is accountable for compliant Medicare Part D and New York State Medicaid pharmacy operations, prior authorization and transition-of-care workflows, delegated oversight, reporting, audit readiness, and continuous improvement of pharmacy programs serving PACE participants.

JOB RESPONSIBILITIES:

• Provide direct supervision, coaching, workload prioritization, performance support, and ongoing development for the Pharmacy Specialist and Clinical Pharmacist Case Manager; coordinate coverage and ensure assigned work is completed accurately and timely.
• Lead daily pharmacy operations, including rejected-claim review, pharmacy inbox management, medication-access escalations, transition fills, discharge medication follow-up, stock coordination, and provider and pharmacy outreach.
• Manage Prior Authorization process for both Duals and Non-Duals. Review and handle escalation from PBM and/or Pharmacy Specialist on a timely basis.
• Oversee clinical pharmacy services, including comprehensive medication reviews, medication therapy problem resolution, medication reconciliation, transition-of-care reviews, prior authorization support, medication safety activities, and participant-centered education.
• Work with Pharmacy Data Analyst and PBM to ensure all pharmacy related reporting for internal (Quality, Compliance, etc.) and external (HPMS, etc.) are completed timely and accurately.
• Serve as the primary operational liaison among Clinical Pharmacy, the IDT, internal departments, prescribers, dispensing pharmacies, the PBM, and other delegated entities; resolve barriers and maintain clear ownership of escalated items.
• Direct delegated oversight and monitoring of PBM and pharmacy vendor performance, including service levels, claims processing, access issues, coverage determinations, denials, appeals, grievances, reporting, and corrective follow-up.
• Monitor pharmacy claims, utilization, cost, quality, and operational trends; identify risks or improvement opportunities and partner with clinical, finance, compliance, quality, and data teams on actionable solutions.
• Oversee recurring and ad hoc pharmacy reports, including CMS Patient Safety and other regulatory, quality, operational, and leadership reporting; validate completeness, accuracy, documentation, and timely submission.
• Maintain audit-ready pharmacy records, trackers, policies, procedures, desk-level workflows, delegation files, and supporting documentation; coordinate responses to internal reviews and external inquiries or audits.
• Develop, implement, review, and update pharmacy policies and standard operating procedures addressing medication access, quality, safety, utilization management, cost effectiveness, transitions of care, reporting, and delegated oversight.
• Lead or support pharmacy quality-improvement and cost-management initiatives, including formulary alternatives, medication adherence, prescribing-pattern review, clinical programs, pilot initiatives, and provider education.
• Coordinate quarterly and ad hoc education for providers and internal staff and ensure pharmacy staff receive training on new requirements, workflows, systems, and departmental expectations.
• Promote consistent processes across PACE sites and community-based care settings; review findings, trends, and staff feedback and implement corrective guidance or process improvements when needed.
• Prepare concise updates for leadership on pharmacy performance, risks, compliance matters, participant-impacting issues, vendor concerns, staffing, and recommended actions.
• Supervise assigned pharmacy employees and provide clear goals, priorities, feedback, and accountability.
• Monitor caseloads, work queues, coverage, deadlines, and service standards; redistribute work or escalate resource needs when appropriate.
• Conduct regular team meetings and individual check-ins and support orientation, competency development, mandatory training, and cross-training.
• Participate in recruitment, selection, onboarding, performance management, and employee-development activities in accordance with Human Resources policies.
• Foster a collaborative, participant-focused, compliant, and continuous-improvement culture.
• Perform other duties as assigned

Schedule: 8:30AM – 5:30PM

Weekly Hours: 40

QUALIFICATIONS:

Education: Graduate of an ACPE accredited School of Pharmacy with a BS in Pharmacy or PharmD required. PGY1 Pharmacy Practice Residency with a focus in ambulatory care or geriatrics, preferred.

Experience:

• Minimum three (3) year managed care pharmacy experience.
• One (1) year ambulatory care pharmacy experience.
• One (1) year long term care or consulting pharmacy experience.
• Demonstrates knowledge in the field of geriatric pharmacy practice.
• Demonstrates excellent written and oral communication skills.
• Skilled in project management with ability to motivate others to see projects through to completion.
• Expert level proficiency with Microsoft Applications.
• Self-motivated, with demonstrated ability to work independently with minimal supervision.

License:

• NY State Pharmacy license required.
• Board Certification in Geriatric or Ambulatory Pharmacy, preferred.

Physical Requirements

Individuals must be able to sustain certain physical requirements essential to the job. This includes, but is not limited to:

• Standing – Duration of up to 6 hours a day.
• Sitting/Stationary positions – Sedentary position in duration of up to 6-8 hours a day for consecutive hours/periods.
• Lifting/Push/Pull – Up to 50 pounds of equipment, baggage, supplies, and ability to lift patients safely and using OSHA guidelines, etc.
• Bending/Squatting – Must be able to safely bend or squat to care for patients, use medical supplies, etc.
• Stairs/Steps/Walking/Climbing – Must be able to safely maneuver stairs, climb up/down, and walk to access work areas Position requires the individual to be able to travel, and walk between sites/locations and work areas throughout the day.
• Agility/Fine Motor Skills - Must demonstrate agility and fine motor skills to operate and activate equipment, devices, instruments, and tools (ie. typing, use of medical supplies, equipment, etc.)
• Sight/Visual Requirements – Must be able to visually assess patients, read orders type/write documentation, etc. with accuracy.
• Audio Hearing and Motor Skills (language) Requirements – Must be able to listen attentively and document information from patients, community members, providers, etc., and intake information through audio processing with accuracy. In addition, must be able to speak comfortably and clearly with language motor skills for customers to understand the individual.
• Cognitive Ability – Must be able to demonstrate good decision-making, reasonableness, cognitive ability, rational processing, and analysis to satisfy essential functions of the job.

Disclaimer: Responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of the company.

Every application is reviewed by our recruitment team. We do not use AI to make hiring decisions or automatically reject applicants. All employment decisions are based on job-related qualifications and applicable employment laws.