Manager, Pharmacy Disease Management (Remote)

Date: Sep 15, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 7859 

 

Position Summary/Position

 

The Manager, Pharmacy Disease Management will have an expert in pharmacy disease management  understanding of all pharmacy ambulatory care disease states including diabetes care, heart failure, hypertension, hyperlipidemia, anticoagulation and other common disease states seen at the ambulatory care setting and will assists the Director of Clinical Pharmacy and Product Strategy  in supporting the strategic direction and oversight of ambulatory care programs and services to support IEHP members and prescribers across all lines of business. The Manager, Pharmacy Disease Management is responsible for developing and running effective and efficient pharmacy related programs, which includes developing and maintaining appropriate metrics to monitor and continually improve processes, performance and quality. The Manager, Pharmacy Disease Management provides direct supervision of clinical pharmacists, student pharmacists, and pharmacy technicians in order to assure operational effectiveness which includes the implementation and adherence to IEHP’s Policies & Procedures that meet Centers for Medicare and Medicaid Services(CMS), the California Department of Health Care Services (DHCS), the California Department of Managed Health Care (DMHC), the Managed Risk Medical Insurance Board (MRMIB), NCQA and other rules/regulations/standards.

Major Functions (Duties and Responsibilities)

 

1. Develop and implement pharmacist disease management programs (including, but not limited to ambulatory care pharmacy, comprehensive management, and medication reconciliation programs) that  improve patient health outcomes. 
2. Ensure high performance of pharmacist disease management program KPIs, staffing models, and goals that align with IEHP’s strategic plan. 
3. Be up-to-date with current peer reviewed literature on pharmacist disease management models.
4. Oversee IEHPs Advanced Practice Pharmacy Elective (APPE) program meets student educational needs and improves IEHP member health outcomes. 
5. Supervise IEHP APPE students to ensure educational and productivity outcomes are met. 
6. Develop clinical pharmacist education and quality assurance programs to ensure interrater reliability and up to date knowledge between pharmacists. 
7. Develop and maintain relationships with accredited California schools of pharmacy in order to grow programs regarding student pharmacists, resident faculty, and research. 
8. Establish internal certification and credentials oversight of IEHP clinical pharmacists performing advanced practice pharmacy work. 
9. Develop pharmacist disease management programs with IEHP Direct primary care providers to develop pharmacist disease management programs that have IEHP pharmacists work to the top of their license. 
10. Develop relationships in collaboration with acute care and long-term care facilities to facilitate pharmacist disease management programs. 
11. Work with pharmacy compliance to ensure that pharmacist disease management programs meet Centers for Medicare and Medicaid Services(CMS), the California Department of Health Care Services (DHCS), the California Department of Managed Health Care (DMHC), the Managed Risk Medical Insurance Board (MRMIB), NCQA and other rules/regulations/standards 
12. Supervise assigned staff (including senior pharmacists, clinical pharmacists, pharmacy technicians, student pharmacists, and other appropriate licensures) in accordance with pharmacy law including performance management, work assignments, training and development, mentor staff, interview and recommend selection of applicants, recommends corrective action, act on time off requests, and ensures compliance to policies, procedures, and regulatory requirements.
13. Participate in quality and continuous process improvement.

Major Functions (Duties and Responsibilities) Cont

Supervisory Responsibilities

Leader: Administers Hires, Terminations, and Performance Reviews

Experience Qualifications

 

Four (4) or more years of individual or combined experience in a clinical pharmacy setting. Project Management experience required.


OR


Completion of a PGY1 Pharmacy Residency in a Health System with experience in pharmacist disease management OR ambulatory care pharmacy OR comprehensive medication management OR medication reconciliation AND one (1) year of relevant work experience. 


OR


Completion of a Pharmacy Residency in a Health Plan, PBM, or HMO setting AND one (1) year of experience as a pharmacist in a Health Plan, PBM, or HMO setting with experience in that one (1) year developing clinical programs such as MTM and Medication Reconciliation.

Preferred Experience

Education Qualifications

 

Pharm. D. from an accredited institution required.

Preferred Education

Professional Certification

Professional Licenses

 

Possession of an active, unrestricted, and unencumbered Registered Pharmacist license issued by the California State Board of Pharmacy required.

Drivers License Required

Yes, must have a valid California Driver's License.

Knowledge Requirement

 

Expertise in pharmacist disease management programs including comprehensive medication management, ambulatory care pharmacy, medication reconciliation, or related is required. Comprehensive Medication Management.

Skills Requirement

 

Microcomputer applications (Microsoft Word and Excel required) for use in all aspects of an office environment. Excellent communication, negotiation, presentation, interpersonal and organizational skills required.

Abilities Requirement

 

Ability to build working relationships, ability to be detail-oriented and organized.  

Commitment to Team Culture

 

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions

 

Schedule may adjust based on business need which may include evenings, holidays, and weekends.

 

Position is eligible for telecommuting/remote work location model upon completing the necessary steps and receiving HR approval. The incumbent approved to telecommute may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs determined by IEHP leadership.

Work Model Location

Telecommute

Physical Requirements

Keyboarding: Traditional - FREQUENTLY
Keyboarding: Touch-Screen - FREQUENTLY
Keyboarding: 10-Key - FREQUENTLY
Hearing: One-on-One - FREQUENTLY
Near Visual Acuity - FREQUENTLY
Communicate: Information/ideas verbally - FREQUENTLY
Sitting - CONSTANTLY
Lighting - CONSTANTLY
Indoors - FREQUENTLY
Regular contacts: co-workers, supervisor - FREQUENTLY
Memory - FREQUENTLY
Understand and follow direction - FREQUENTLY
Regular and reliable attendance - CONSTANTLY

A reasonable salary expectation is between $168,584.00  - $223,371.20, based upon experience and internal equity.

 

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region. With a provider network of more than 7,000 and a team of more than 2,500 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.

 


Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles