Director, Pharmacy

The Director of Pharmacy is responsible for supporting the AVP of Medical Cost Containment in the implementation, process improvement, and optimization of clinical programs. This role focuses on analytic measurement and improvement of medical management within assigned programs, which may include pharmacy and other operational processes.

Responsibilities

• Serve as a business owner for medical product management needs specific to pharmacy program and establish key performance indicators, identify opportunities, and drive business goals.
• Manage a team of 8 pharmacists through a remote setting, overseeing a countrywide prior authorization program specific to workers compensation claims.
• Maintain a solid understanding of AmTrust's mission, vision, and values while upholding the standards of the organization.
• Monitor, analyze, and trend clinical program data to assist in the development, implementation, and driving of key initiatives.
• Evaluate new and emerging regulations as they impact the program and problem-solve for implementing change and producing outcomes.
• Optimize clinical programs for nurse and adjuster efficiency, streamline the injured employee experience, and enhance positive claim outcomes.
• Identify best practices and trends in the industry, participate in evaluating new and emerging technologies and treatments to determine possible incorporation into programs.
• Participate in office managed care and clinical operational reviews.
• Manage project development/enhancements through coordination with WC operations.
• Keep current with market trends and demands.
• Perform other functionally related duties as assigned.

Requirements

• PharmD. or RPH
• Experience with Workers Compensation insurance carrier setting or related industry
• Demonstrated results in developing strategic plans and executing key initiatives
• Proficient in data evaluation and visualizations
• Excellent English communication skills, both written and verbal, as well as strong analytic, documentation, and organizational skills
• Efficient with multitasking between projects
• Proficiency in all Microsoft Office products including Project, Word, Excel, PowerPoint, Visio, and SharePoint
• Ability to prepare and effectively communicate presentations, interpret/develop reports, metrics and improvement plans, and to interact collaboratively and work effectively with a multi-functional team and throughout the organization; foster an environment of shared responsibility and accountability

Preferred

• 2+ years of managing projects and/or vendor relationships
• 2+ years of experience writing SQL queries, creating stored procedures, views, and functions
• 2+ years of management experience preferred
• Project Management Office (PMO) experience
• Knowledge of workers' compensation laws and regulations, medical billing (ICD9/10, CPT, HCPCS)
• Experience with State and external accreditation managed care audits and with writing and implementing program level policy and procedures

The expected salary range for this role is $130,000-$155,000. Please note that the salary information shown above is a general guideline only. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations.