System Manager Compounding and Clean Rooms Operations

Job Description Summary

The Pharmacy Manager provides compounding and clean room leadership and oversight to the Pharmacy Services ICCE and reports directly to the System Executive Director of Inpatient Pharmacy and Compounding. Responsibilities include ensuring adherence to United States Pharmacopeia (USP) standards, particularly those related to sterile compounding, nonsterile compounding, the handling of hazardous drugs and radiopharmaceuticals, and other relevant USP chapters across the Medical University of South Carolina Health System. In addition, the Pharmacy Manager will provide oversight and monitoring of all compounding and clean room activities across the system to include direct supervision of the Compounding Center at Ellis Oaks. Additional responsibilities include collaborating with interdisciplinary team members to optimize the delivery of care, ensuring relevant safety, regulatory, certification and/or accreditation standards are maintained, and various required human resource functions.

Entity

Medical University Hospital Authority (MUHA)

Worker Type

Employee

Worker Sub-Type​

Regular

Cost Center

CC000603 CHS - Pharmacy - Administration Quality and Safety Services (Main)

Pay Rate Type

Salary

Pay Grade

Health-35

Scheduled Weekly Hours

40

Work Shift

Job Description

• Actively participates in process improvement and quality related initiatives across the system, leading the system quality committee for compounding and clean room management
• Develops KPIs and monitors performance metrics to include oversight of the system platform for operational compliance tracking.
• In collaboration with pharmacy leadership team members, develop, evaluate and revise departmental policies and procedures.
• Serves as the content expert in compounding standards, quality related questions and provides assistance during urgent quality incidents
• Works with other departments (e.g. Information Solutions, facilities) on system enhancements to uphold compliance standards.
• Manage Assessments of Risk for Hazardous medications (Sterile and non-sterile) in collaboration with pharmacy leaders and the drug information team
• Implement systemwide standardization of products, equipment, and software, where applicable, related to compounding to streamline processes, optimize operations and offer efficiencies and cost savings for the MUSC System. Will act as primary contact person for all vendors. Provides support when intervention is required with vendors to support quality.

• Perform quality visits to conduct assessments and identify critical compliance gaps. Communicate findings, targeted learning solutions, and corrective action plans to appropriate stakeholders as needed.
• Develop and support initial and required (e.g. annual) compounding training and education for the department
• In collaboration with local pharmacy leadership, ensure staff members are trained and able to demonstrate the knowledge and skill necessary to provide compounding services upon hire and at least annually
• Serve as the content expert in compounding standards and clean room management
• Provides pharmacy in-service education when needed or requested
• Participates in the education activities of the department and shows evidence of such
• Precepts pharmacy and pharmacy technician students and/or residents during rotations.

• Serves as the liaison between each pharmacy and the Pharmacy ICCE Leadership team.
• Oversees the operations of the Compounding Center at Ellis Oaks
• In collaboration with local pharmacy leaders, enforces departmental policies and procedures and ensures compliance with pertinent state and federal laws and regulations, including but not limited to Joint Commission, USP, and SC Board of Pharmacy.
• Ensures satisfactory relationships with other departments.
• Facilitates solutions to problems and resolves complaints regarding departmental services and activities.
• Sets example for other pharmacists and technicians in work quality, efficiency, productivity, and personal conduct standards.
• Participates on departmental, medical center and system committees.
• Attends required meetings and trainings

• Routinely works side-by-side with pharmacy team members involved in compounding practices at each facility to observe, coach team members and identify needs.
• Collaborates with other pharmacy ICCE leadership to ensures compliance with controlled substance policies and procedures according to DHEC and DEA regulations for associated areas, when used in sterile compounding

Additional Job Description

Doctoral of Pharmacy