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

Community Care Services - Troy, MI

Full-time - Mid Level

Troy, MI

Ambulatory Health Care Services

About the position

The Pharmacy Coordinator is a licensed pharmacist responsible for coordinating the administration of pharmacy benefit management programs within the Pharmacy Care Management Department. This role involves designing, implementing, and improving pharmacy benefit management programs, ensuring compliance with regulatory standards, and managing vendor relationships. The coordinator also plays a key role in educating departmental staff and enhancing their skills.

Responsibilities

• Administers, designs and implements changes in both existing and new pharmacy benefit structures and processes.
• Assures assigned daily operations are high quality and efficient and identifies opportunities for improvement.
• Creates monitoring, compliance and audit programs as needed.
• Assures compliance with accreditation and regulatory requirements such as NCQA, Medicare, FWA, federal & state government regulations.
• Develops guidelines and protocols for new drugs.
• Designs, documents and maintains policies, procedures, manuals, databases, lists, webpages and reports as assigned.
• Coordinates the business relationship and contracts with vendors, contractors, and customers as assigned.
• Serves as an educator and resource for the 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.