Job Information
Molina Healthcare National Account Mgr, Pharm Svcs in Kentucky
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.
Job Duties
Provide oversight of the PBM for the Health Plan, including tracking of Service Warranties and Performance guarantees
Standardize operational processes for health plan pharmacy services across pharmacy enterprise including documentation of processes. (i.e. enrollment, encounters, national vendors, user provisioning)
Drive and coordinate Health Plan and/or Corporate projects.
Vendor management including oversight, corrective action plans, (Pharmacy Benefit Manager, Medication Therapy Management, etc)
Training support relative to health plan pharmacy services (Lock-In, Nurse Advice Line, Member/Provider Contact Center)
Support state health plan functions, goals, and initiatives.
Identify trends and implement process changes
Liaison with Member and Provider Service Teams for both Molina and PBM
Maintain Pharmacy SharePoint and provide direction for website
Develop both Routine and Adhoc Member and Provider Communications
Support Pharmacy Manager/Director in reviewing and updating corporate Policies and Procedures to assure compliance with contractual and regulatory requirements
Provide Ad Hoc Reporting
Be the subject matter expert for pharmacy compliance and legislative regulations
Support Corporate Pharmacy Quality Department
Support and complete all audits as required (SOX, CMS, internal, Network)
Primary liaison to PBM for Health Plan
Job Qualifications
REQUIRED EDUCATION :
Associate’s Degree or equivalent combination of education and experience
REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :
5+ years Managed Care, Pharmacy or PBM experience.
Able to present ideas and information concisely to varied audiences
Excellent verbal and written communication skills
Knowledge of processes and systems to develop and deliver necessary training to departmental staff and internal customers
Positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors
Proficiency in compiling data, creating reports and presenting information, including expertise with MS Excel
Ability to meet established deadlines
Ability to function independently and manage multiple projects
REQUIRED LICENSE, CERTIFICATION, ASSOCIATION :
PREFERRED EDUCATION :
Bachelor's Degree
PREFERRED EXPERIENCE :
Health Plan Pharmacy Operations experience
PREFERRED LICENSE, CERTIFICATION, ASSOCIATION :
Active and unrestricted State 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: $59,810.6 - $129,589.63 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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