Pharmacy Operations Manager

About the role

Provides oversight of all contracts, addendums, pharmacy registration and credentialing processes pertaining to 340B contract pharmacy, in-house retail pharmacy, clinic medication/vaccine, and 340 Program. Provides oversight and supervision of all auditing practices conducted as required by regulatory agencies. Acts as Primary Contact for HRSA/OPA, DEA, OHA VFC, NCPDP and OBOP.

Responsibilities

• Serves as primary internal and external program manager and liaison for all 340B-related matters.
• Ensures that 340B policies and procedures are developed and implemented according to organizational, regional, state, and federal requirements and guidelines.
• Engages with senior leadership and participates in decision-making processes related to 340B implementation, oversight, and compliance processes.
• Maintains relationship as primary contact for all Third-Party Administrators related to contract pharmacy.
• Manages relationships, billing services, and compliance with contracted 340B pharmacies.
• Evaluates 340B contracts. Makes recommendations for contract maintenance and negotiations.
• Oversees and directs 340B Coordinator to develop and deliver 340B program communication, staff training and education.
• Oversees and directs 340B Coordinator on 340B program projects, optimization, and problem resolution.
• Maintains relationship as primary contact for all Third-Party Administrators related to contract pharmacy.
• Registers as “Primary Contact” in OPAIS and maintains accurate representation of all entity-owned and contract pharmacies.
• Informs Director of Pharmacy Services on monthly Oregon Primary Care Association Pharmacy Leaders call.
• Oversees all pharmacy licensing and credentialing processes as required by state and federal agencies.
• Reviews Oregon Board of Pharmacy licensure for each pharmacy staff member annually.
• Primary contact for maintaining current, new, and revoked CSOS certifications.
• Ensures all Pharmacy Benefit Manager contracts are reviewed, and enrollments are up to date.
• Ensures pharmacy maintains compliance with all PBM contractual requirements.
• Reviews wholesale drug distribution agreements and act as primary contact for drug wholesalers.
• Provides oversight of prescription insurance claims reconciliation, reimbursement and profitability. Including MAC appeals when warranted.
• Partners with Director of Pharmacy to ensure all pharmacy policies and procedures are up to date and reflect current laws, rules and regulations as required by state and federal agencies.
• Evaluates pharmacy inventory and supplies for potential cost-savings strategies.
• Works directly with retail pharmacy managers to ensure fiscally responsible inventory management.
• Collaborates directly with Director of Pharmacy to evaluate the financial performance of in-house pharmacy operations, including revenue growth, expense management, budget adherence, and potential additional revenue sources.
• Partners with 340B Coordinator and accounting to review and reconcile Medicare Transaction Facilitator/Rebate Model payments, including submission of “good faith inquiries” when appropriate.
• Works directly with our in-house Third-Party Administrator to ensure accurate claims processing and inventory accumulations.
• Provides pharmacist staffing support within retail pharmacy operations during staffing shortages, vacations, sick calls, or other coverage gaps.
• Works with Vaccine Coordinator to ensure policies, procedures, guides, and standing orders are developed and implemented according to organizational, regional, state, and federal requirements and guidelines for the Vaccine, Vaccine for Children (VFC), and Medication Management programs.
• Acts as expert on OHA ALERT and VFC Regulations and primary contact for OHA/Oregon Immunization Program.
• Oversees VFC Site Visits with OHA/VFC Inspector and Vaccine Coordinator, respond to follow-up email from visit with corrective action plan if there are any findings during the visit.
• Acts as final determinant of vaccine viability regarding temperature and storage excursions for all clinic locations.
• Attends Quarterly Deschutes County VFC Coalition Meetings and any other education and training specific to MA/RN VFC Coding and Compliance.
• Partners with Vaccine Coordinator to develop and deliver vaccine and medication management program communication, staff training and education.
• Partner with Vaccine Coordinator and Medication Coordinator on vaccine and medication management program process improvement initiatives, projects, and problem resolution.
• Provides leadership, oversight, and strategic direction for Prescription Refill operations to ensure safe, efficient, and patient-centered medication refill and prior authorization services across the organization.
• Holds the Prescription Refill Specialist Supervisor accountable for team performance, operational metrics, staff engagement, workflow compliance, and departmental goals.
• Supports complex medication access issues, insurance barriers (including prior authorizations), and formulary changes.
• Collaborates with Providers, Nursing, Pharmacy, and IT/EHR teams to optimize medication access workflows.
• Collaborates with Clinical Pharmacy Manager on implementation and oversight of refill protocols.
• Manages performance of the team, conduct monthly meetups and provide real-time and consistent coaching with all direct reports.
• Ensures accountability of team, including but not limited to adherence with policies, procedures, guidelines, workflows, etc., addressing attendance, performance, and behavior concerns including corrective action if necessary.
• Consults with Human Resources to support employee relations, performance achievement, training, employee engagement, etc.
• Holds consistent and timely team meetings to communicate organization, site, and/or department information, changes, initiatives, etc.
• Effectively monitors onboarding of new hires, ensure on-going training and development for all staff.

Qualifications

• A minimum of 5 years as a licensed pharmacist required.
• Retail Pharmacy experience required.
• Experience as pharmacist-in-charge preferred.
• People management experience preferred.
• Experience developing policy and procedures, workflows, and providing staff training preferred.

Education, certification and licensure

• Doctor of Pharmacy or bachelor’s degree in pharmacy required.
• Active Oregon Board of Pharmacy license required.
• CPR certification required.
• Valid Oregon driver’s license required.
• Apexus Advanced 340B Operations certificate preferred.

Skills & Knowledge

• Working knowledge of 340B program requirements required.
• Working knowledge of program management including experience with supporting continuous process improvement required.
• Excellent communication skills and ability to interact with a diverse population and professionally represent Mosaic Medical, strong teamwork and collaborative skills, ability to multi-task, attention to detail, excellent organizational skills, customer service, particularly in dealing with stressful personal interactions.
• Basic to intermediate ability and experience in computer applications, specifically electronic medical records system, Pharmacy software, and MS Office.