Director of Pharmacy Services (Health Plans)

• Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan.

  As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.

  This is a remote position in which we are able to employ in the following states: Alabama, Alaska, Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin

• JOB SUMMARY/PURPOSE
  • Provides comprehensive management and leadership for the SHP Pharmacy Department. Manages the SHP pharmacy benefit for all product lines. This includes oversight of the prior authorization process, formulary management, regulatory compliance, and relationships with SHS and contracted pharmacies, Pharmacy Benefit Manager, including contracting for rebates. Coordinates clinical programs and services offered by the department including educational programs for members, providers, and SHP staff.
• EXPERIENCE/EDUCATION/QUALIFICATIONS
  • Current unencumbered Oregon pharmacist license required.
  • Three (3) years clinical pharmacy experience required.
  • Three (3) years healthcare leadership experience required.
  • Experience in managed care or an associated field preferred.
  • Residency and Board certification preferred.
• KNOWLEDGE/SKILLS/ABILITIES
  • Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
  • Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
  • Critical thinking – Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.
  • Communication and team building – Leads effectively with excellent verbal and written communication. Delegates and initiates/manages cross-functional teams and multi-disciplinary projects.
• PHYSICAL DEMANDS

  • Rarely (1 - 10% of the time)

    Occasionally (11 - 33% of the time)

    Frequently (34 - 66% of the time)

    Continually (67 – 100% of the time)

    LIFT (Floor to Waist: 0"-36") 0-20 Lbs LIFT (Knee to chest: 24"-54") 0 - 20 Lbs LIFT (Waist to Eye: up to 54") 0 - 20 Lbs CARRY 1-handed, 0 - 20 pounds CARRY 2-handed, 0 - 20 pounds KNEEL (on knees) BEND FORWARD at waist CLIMB - STAIRS

    STAND WALK - LEVEL SURFACE ROTATE TRUNK Standing REACH - Upward PUSH (0-20 pounds force) PULL (0-20 pounds force)

    SIT ROTATE TRUNK Sitting REACH - Forward MANUAL DEXTERITY Hands/wrists FINGER DEXTERITY PINCH Fingers GRASP Hand/Fist

    None specified

Unencumbered Oregon pharmacist license, 3 years of clinical pharmacy experience, and 3 years of healthcare leadership experience required; managed care, residency, and board certification preferred.

Key Responsibilities

• managing pharmacy benefits
• overseeing authorizations
• leading clinical programs

Job Details

• Category: Healthcare Services - Pharmacy
• Seniority: Mid Level
• Commitment: Full Time
• Workplace: Remote — Alabama or Alaska or Arizona or Arkansas or Connecticut or Florida or Georgia or Idaho or Indiana or Iowa or Kansas or Kentucky or Louisiana or Maryland or Michigan or Mississippi or Missouri or Montana or Nebraska or Nevada or New Hampshire or New Mexico or North Carolina or Oklahoma or Oregon or Rhode Island or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or West Virginia or Wisconsin
• Languages: English

Benefits

• 401k matching
• Generous paid time off
• Tuition reimbursement

About Samaritan Health Plans

A health plan provider serving employees, employers, and Medicare and Medicaid members. — Industry: Healthcare