Associate Director Pharmacy Utilization Management

Primary City/State:

Arizona, Arizona

Department Name:

Pharm Benefits Mgmt-Misc

Work Shift:

Day

Job Category:

Pharmacy

Pharmacy careers are better at Banner Health. We are committed to developing the careers of our team members. We care about you, your career today and your future. If you’re looking to leverage your abilities – apply today. 

In this role of Associate Director Pharmacy Utilization Management, you will oversee the Pharmacists who handle Prior Authorization for Medicare and Medicaid. Experience in managed Medicaid or Medicare Advantage, and Prior Authorization is preferred. You will also be responsible for the management of the UM Pharmacists. You will ensure accurate clinical decision making and will serve as a point of escalation for difficult clinical issues. You are expected to form a dyad with the Associate Director Pharmacy Technician, who oversees the pharmacy technicians and has a more operational focus. Together with the dyad leader, you are responsible for ensuring operations meet or exceed all regulatory requirements. You must collaborate closely with other departments including Grievance and Appeals, Customer Care, Claims, and the Medical Utilization Management Teams. You will manage results and reporting results to various stakeholders including senior leaders within Banner Health.

This is a remote position working Monday - Friday within normal business hours 8M - 5PM with some flexibility. There may the need to handle issues on the weekend.

Banner Pharmacy Services is a recognized leader in healthcare and trusted partner in proactively providing innovative pharmacy services through excellence in integration, care coordination, medication management and services to make a difference in people's lives. Clinical Pharmacy Services is responsible for the management of the Banner formulary, development of standardized system wide clinical pharmacy services, and management of adverse drug event preventions. Clinical Pharmacy Services provides collaborative drug therapy management and educational interventions in patient care to optimize medication therapy, improve outcomes, promote wellness, and disease prevention. As a division, Banner Pharmacy services provides excellent patient care across our entire continuum through convenient access, improved medication outcomes and innovative pharmacy practices.

POSITION SUMMARY

This position is responsible for providing managerial and leadership support for Pharmacy’s Population Health programs and staff. Plans, directs, monitors, evaluates, and improves the provision of population-health pharmacy services; including but not limited to system and plan performance in assigned business areas. Assures adequate staffing according to workload while maintaining expected productivity levels. Develops standards of work performance, orientation and training programs. Promotes and demonstrates effective inter-disciplinary collaboration. Ensures the functions of the department are consistent with policies and procedures. Responsible for maintaining robust policies and procedures, clinical tools, and resources. Adheres to local, state, and federal laws regarding the profession of pharmacy practice.

CORE FUNCTIONS

1. Responsible for oversight of routine operations of Pharmacy Population Health Services. Provides leadership and direction to the pharmacy staff; including pharmacists and residents, pharmacy interns, pharmacy technicians, and support staff. Promotes positive relations and actively contributes to a supportive work environment. Fosters a team environment within the department and various services across the system. Participates as a pharmacy preceptor (students and residents) and, as assigned, member of the Residency Advisory Council.

2. Leads the recruitment, selection, orientation, competency assessment and evaluation of assigned employees. Serves as a change agent, role model, and facilitator for education, professional development and research. Fosters ongoing career development for assigned employees.

3. Manages assigned population health management activities; including but not limited to clinical quality programs and services, member engagement activities, provider outreach and engagement activities, utilization and medical management functions, customer service functions, data management/manipulation, and coordination with a variety of care providers, including physicians, nurses, pharmacists, care managers, and other members of the healthcare team. Operates within the budgetary guidelines of the department/system. Accountable for financial stewardship by monitoring appropriate fiscal controls and resources, equipment and supplies. Plans efficient and effect