Are you interested in joining a rapidly-growing, dynamic Pharmacy Benefit Management company working in a full-plate plus environment? EMPLOYERS HEALTH NETWORK HOLDINGS, LLC / SOUTHERN SCRIPTS, LLC is growing and looking for incredible talent! Employers Health Network Holdings, LLC/Southern Scripts, LLCprovides comprehensive pharmacy benefit management services and healthcare plans for employers. We offer a Prescription Benefit Management option that restores balance between the need for sound prescription management strategies and meeting the health needs of a company's employees and their families.
Currently, we are experiencing accelerated growth in a rapidly changing industry. There's never been a better time to join our team. We are seeking motivated, coachable, self-driven individuals that possess a servant leadership philosophy and are looking for long term positions at Employers Health Network Holdings, LLC/Southern Scripts, LLC.
Director of Pharmacy (Managed Care)
The Director of Pharmacy (Managed Care) is responsible for assisting with the development and expansion of services to positively impact the health of our client's employees and enhance clinical and economic performance for existing clients.
Role and Responsibilities
Interface with key clients to support pharmacy benefit management (PBM) clinical operations
Engage client pharmacy director, pharmacy staff, or pharmacy benefit personnel via telecommunication
Provide dynamic and consultative management of clinical services and oversee day-to-day operational activities
Manage all internal and external inquiries from receipt through to resolution
Communicate clinical operational program initiatives, changes and quality improvement related items to customers, with a key focus on health plans, formulary management and clinical recommendations.
Analyze drug usage reports to identify problems and provide appropriate solutions
Develop strategies to decrease pharmacy costs for members and the company
Provide and present clinical drug information/drug evaluation reviews and suggestions to clients and their appropriate clinical committee(s)
Build and foster relationships with client contacts through quality clinical service delivery
Lead and participate in weekly, quarterly, and ad hoc clinical meetings with customers
Participate in face-to-face client meetings as needed
Ensure client satisfaction throughout plan implementation and plan administration
Review and process coverage determination and appeal requests including quantity limit exceptions, tier exceptions, and non-formulary exception requests
Oversight of Prior Authorization programs and pharmacy audit programs
Assist in performing drug reviews, developing statewide and national clinical programs, and supporting utilization management
Aid in preparation and submission of formulary files which may include marketing documents and web-based search files
Other duties as assigned
Required Skills and Competencies
Working knowledge of clinical and formulary issues and the ability to independently identify, research and resolve issues.
Pharmaceutical and medical knowledge necessary to effectively discuss drug therapy issues with other clinicians
An intelligent and articulate individual who can relate to people at all levels of an organization and possesses excellent communication skills
A decisive individual who possesses a detail-oriented perspective
A strategic planner with sound technical skills, analytical ability, good judgment, and strong operational focus
Ability to work with peers in a team effort
Demonstrated ability to manage multiple priorities and deadlines
A well-organized and self-directed individual who can work with minimal amount of supervision
Proficient in Microsoft Office and industry related software programs
Ability to work extended hours, weekends, and holidays pursuant with industry demands
Willingness to travel
Ability to interface with clients, professionally and accurately, with health plan and/or employer group experience
Past experience equivalent to a Managed Care Pharmacy Director
This position has supervisor responsibility as head of the Clinical Department and each program/division reporting to this role.
Position Type and Expected Hours of Work
This is a full-time, salaried position. Days and hours of work are Monday through Friday, 8:00 a.m. to 5:00 p.m. The Department Head position will have occasional after-hours or weekend duties.
This position requires 25% travel to our other locations.
Required Education and Experience
Prior experience as a Managed Care Pharmacy Director or equivalent experience
Bachelor's degree in pharmacy or Pharm.D.
Must maintain an active pharmacist license in good standing in at least one state
Minimum 2 to 5 years' general pharmacy or pharmacy benefit management experience
Internal Number: 001
About Southern Scripts
Southern Scripts simplifies the complexities of navigating through the Pharmacy Benefit Manager world by giving the employer group complete freedom, control, and choice as to how they structure their plan. The employer group has the option to choose how they want their prescription benefit plan to function, which pharmacies they want to work with, what reimbursement rates they want to pay pharmacies, what medications they want to cover, and so forth.
Southern Scripts simplifies the cost of pharmacy benefit management services. Our pricing structure is clear cut with no hidden tactics. We do not “nickel and dime” clients with additional fees for essential components of good pharmacy benefit management including Drug Utilization Report, an attentive Customer Service Call Center, and Prior Authorization Programs.
Straight-forward and clear cut methodology is utilized in all of our pricing.
We do not own a mail order facility nor do we force mail order.
All rebates are 100% accounted for and disclosed to the plan sponsor.
Southern Scripts offers a comprehensive health and welfare benefits program which includes options of medical, dental, vision, life insurance, long-term and ...short-term disability insurance, etc. We also offer a competitive 401K retirement plan. After 90 days of employment, employees become eligible to accrue paid time off according to our accrual schedule.