Senior Director, Clinical Pharmacy Services

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
 

This is a remote role, but ideal candidates will reside in EST or CST time zones.

Position Purpose: Perform duties to develop, direct and implement a pharmacy benefit management program. Aid in formulating and administering related organizational policies and procedures, including pharmacy service quality, pharmacy utilization management and achievement of Company goals for pharmacy and medical programs.

• Establish the strategic vision, objectives and policies and procedures for the pharmacy program for the health plans ensuring alignment with the corporate strategic vision
• Develop clinical and utilization management criteria for the appropriate use of drugs relative to their Preferred Drug List positioning and criteria related to coverage for specialty biopharmaceuticals
• Oversee the development, implementation and maintenance of corporate pharmacy policies and procedures
• Develop and provide documents for the Pharmacy and Therapeutics Committee review
• Perform various analyses to measure the impact related to the provision of a cost-effective pharmacy benefit
• Develop Drug Utilization Review initiatives to identify and optimize drug therapy
• Analyze rebate opportunities and balance brand drug Preferred Drug List placement with lowest net cost
• Analyze specialty biopharmaceuticals for preferred drug therapy consistent with available vendor contracting
• Serve as the point of contact for the health plans for questions related to coverage, review of appeals and proposed changes in criteria
• Support provider education initiatives and improvement in HEDIS measures

Education/Experience: Bachelor’s degree or advanced degree (PharmD., M.S) in pharmacy. 7+ years of clinical pharmacy care, contracting, and quality improvement experience including management experience. Thorough knowledge of pharmaceutical care and pharmacy benefit management practices. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.

License/Certification: Registered Pharmacist with an unrestricted license in the state of employment with eligibility for pharmacy licensure elsewhere. Valid driver’s license may be required.

Previous Director+ level experience highly preferred

Managed Care experience highly preferred

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.  Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act