AmeriHealth Caritas Pharmacy Director in Philadelphia, Pennsylvania
AmeriHealth Caritas Delaware is excited to have been chosen as one of the Medicaid managed care plans for the Diamond State Health Plan and Diamond State Health Plan- Plus programs. Backed by a national organization, we have long-term experience serving the Medicaid population in neighboring states. We are committed to delivering health care through innovative services and programs and are looking forward to helping Delaware become an even healthier state.
The Pharmacy Director provides oversight for all pharmacy activities related to the contract and serves on the CHC-MCO P&T Committee. This position is the liaison to our wholly owned subsidiary PerformRx, a pharmacy benefit manager, regarding all regional pharmacy activities. The Pharmacy Director is responsible for the effective collaboration and implementation of plan programs.
- Develops and implements new systems and programs; analyzes and evaluates ongoing effectiveness; and identifies and implements enhancements for the Drug Therapy Management program, pharmacy queue improvement, care gaps, PerformMAX and other programs as they are identified.
- Reviews pharmacy benefit management policies and procedures for compliance with applicable Delaware requirements.
- Designs and monitors performance reports related to pharmacy benefit management operations for the plan.
- Monitors pharmacy trends and makes recommendations for process, product and program improvement.
- Reviews pharmacy benefit management operational processes. Works with PerformRx, to ensure that any deficiencies in service are identified and corrected.
- Reviews PerformRx’s submissions to agencies, represents plan and participates on the Pharmacy and Therapeutics Committee. Supports the Quality Assurance Performance Improvement Committee.
- Keeps abreast of industry trends and regulatory changes and evaluates their effect on pharmacy contracts and services.
- Provides pharmaceutical support to specific projects.
- Designs and implements cost-containment initiatives specific to the plan and coordinates initiatives between the plan and PerformRx. Acts as a liaison to behavioral health providers for individual members’ problem issues.
- Three to five years of clinical pharmacy experience in a managed care setting.
- Previous relevant experience at an appropriate level of independence, complexity and authority in a managed care or health care environment.
- Licensed Pharmacist in the state of Delaware required.
- Bachelor’s degree in Pharmacy.
- PharmD, Master’s degree or equivalent business experience preferred.