Coordinator of Pharmacy Benefits (Pharmacist) - Utilization Management - Fulltime

Henry Ford Health - Troy, MI

Full-time - Mid Level

Troy, MI

Ambulatory Health Care Services

About the position

The Pharmacy Coordinator is a licensed pharmacist responsible for managing and improving pharmacy benefit management programs within the Pharmacy Care Management Department. This role involves designing, implementing, and overseeing various pharmacy program components, ensuring compliance with regulatory standards, and enhancing the skills of departmental staff.

Responsibilities

• Administers, designs and implements changes in pharmacy benefit structures and processes.
• Assures assigned daily operations are high quality and efficient, identifying opportunities for improvement.
• Creates monitoring, compliance and audit programs as needed.
• Ensures compliance with accreditation and regulatory requirements such as NCQA, Medicare, and federal & state regulations.
• Develops guidelines and protocols for new drugs.
• Designs, documents and maintains policies, procedures, manuals, databases, lists, webpages and reports as assigned.
• Coordinates business relationships and contracts with vendors, contractors, and customers.
• Serves as an educator and resource for pharmacy staff and others as assigned.
• Represents the department at internal and external meetings.
• Supports the prior authorization and appeal process as needed.

Requirements

• Registered Pharmacist in the State of Michigan.
• Minimum one year of managed care or pharmacy benefit management experience.
• Excellent analytical and project management skills.
• Exemplary oral and written communication skills.

Benefits

• Competitive health plan options including CDHPs, PPO, and HMO plans.
• Dental and eye care coverage.
• Tuition assistance.
• Family forming benefits.
• Discounts to dozens of businesses.