Sr Manager, Clinical Pharmacy Operations

Who We Are

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. 

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health.

Job Summary

Under the direction of the Director, Clinical Pharmacy Operations, the Senior Manager, Clinical Pharmacy Operations is responsible for managing a team focused on the execution of clinical pharmacy programs and strategies to mitigate cost, improve adherence, and maintain affordability. Leads the implementation and maintenance of evidenced based, cost-effective program for all lines of business in all market segments. Guides clinical pharmacy team in the implementation of clinical programs, aligned with enterprise goals, including medical cost reduction and administrative simplification for members and providers. Ensures compliance with state and federal regulatory and accreditation requirements in all geographies. Collaborates with PBM to optimize member experience and clinical outcomes. Directs support functions for the Pharmacy and Therapeutic’s committee in collaboration with the pharmacy medical director. Leads and manages the work of the clinical pharmacy team, effectively delegating as appropriate and holding team members accountable for meeting deliverables and achieving results. Sets priorities and ensures that the key deliverables of the team stay on track.

Job Description

Key Responsibilities/Duties – what you will be doing (top five):

• Lead the maintenance of enterprise formularies and pharmacy programs, for all lines of business and geographies. Lead the annual review of all formularies and clinical pharmacy strategies, including a competitive analysis, cost-benefit review of programs, and trend review by therapeutic class. Work with Pharmacy Benefit Manager (PBM) to monitor pharmacy spend and performance to identify opportunities for improved management. Ensure formulary management activities meet state and federal requirements.
• Identify initiatives for medical cost reduction, administrative cost reduction and/or market competitiveness. Lead the business evaluation and implementation through collaboration and communication with other departments and stakeholders and Pharmacy TCOC (Total Cost of Care) team.
• Represent clinical pharmacy interests at inter-departmental meetings and on project teams. Identify implications for Pharmacy Services department and facilitates/coordinates follow-up with others in the department. Disseminate information and provides periodic updates as needed.
• Hire, train, supervise and evaluate the activities of the Clinical Pharmacy Team staff.  Provide coaching, feedback, and direction to staff to insure the successful achievement of their goals and that of Point32Health.  Prioritize projects and initiatives and support staff in the resolution of escalated issues.  Serve as a role model for staff and foster a collaborative and team-based approach both within the Department and interdepartmentally.  Effectively manage change and constant prioritization based on strategic and operating goals
• Direct the research and analysis of identified problems and issues, the validation of findings and the development and communication of plans for problem resolution.  Support staff in the identification and verification of problems and provide guidance in the development and implementation of appropriate solutions.  Identify for the Director those issues of broader complexity and/or sensitivity which may require action by the Director and recommend solutions for those issues having broader complexity or ramifications.
• Participate in and/or lead departmental and interdepartmental meetings, including but not limited to Pharmacy & Therapeutics Committee, Drug Coverage Committee, Specialty Pharmacy committees, and Pharmacy Compliance. 
• Oversees team compliance with all federal and state laws and accr