Easter Seals Jobs

Job Description

Job Summary

Molina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal and state laws. Jobs in this family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics with regard to patient outcomes, medications safety and medication use policies).

Knowledge/Skills/Abilities

The Supervisor, Pharmacy Operations/ Call Center supervises Pharmacy Technicians, Pharmacy Service Representatives, and/or Pharmacy Internal Monitors who support the processes involved with the review of non-formulary drugs or other drugs requiring prior authorization.

• Supervises the unit's daily operations to ensure prompt and appropriate processing of requests for non-formulary or prior authorized required drugs.

• Ensures that average phone call handle time, average speed to answer, and average hold time are compliant with CMS regulations.

• Ensures that adequate staffing coverage is present at all times of operation.

• Assists Manager with monitoring and oversight of Molina's contracted Pharmacy Benefit Manager (PBM) for pharmacy contractually delegated functions. (NEWLY ADDED BY SW)

• Responsible for KPI reporting to Compliance department on a monthly basis.

• Participates, researches and validates materials for both internal and external program audits.

• Acts as liaison to internal and external customers to ensure prompt resolution of identified issues.

• Assists Manager or Director in the collection and tabulation of data for reporting purposes and maintains files of confidential information submitted for review.

• Assures that activities and processes are compliant with CMS, NCQA guidelines and Molina

policies and procedures.

• Participates in the daily workload of the department, performing Technician and/or Representative duties as needed.

• Interviews potential technician and service representative job applicants and provides hiring recommendations to Manager or Director.

• Provides coaching for the technicians and representatives and helps identify and provide for training needs, in collaboration with the Manager or Director.

• Communicates with practitioners and pharmacists.

• Collaborates with and keeps Manager or Director apprised of operational issues, including staffing resources, program and system needs.

• Assists with development of and maintains policies and procedures as needed.

• Participates in the development of programs designed to enhance preferential or required targeted drugs or supplies..

Job Qualifications

Required Education

• Associate's Degree or equivalent combination of education and experience in lieu of degree.

• Pharmacy Technician who has completed a Certified Pharmacy Technician Training Program.

Required Experience

• 3 - 5 years experience as a Pharmacy Technician, including at least one year in health care delivery.

• Minimum of one year Pharmacy Prior Authorization experience.

• Knowledge of prescription drug products, dosage forms and usage.

• Proficiency in Windows system applications.

Required License, Certification, Association

Active and unrestricted National or State Pharmacy Technician license.

Preferred Education

Bachelor's Degree or equivalent combination of education and experience.

Preferred Experience

• 5-7 years; previous supervisory experience.

• Knowledge of or experience with decision analysis and data analysis tools, such as SQL, MS Access, Excel.

• Call Center experience preferred.

Preferred License, Certification, Association

National Pharmacy Technician license.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $43,888 - $80,464.96 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.