Manager, Pharmacy Experience and Access
$147,900–$214,030 year
RemoteUnited States
United StatesRemoteFull Time$147,900–$214,030 yearLarge
Full TimeLarge
Job Summary
Lead the Pharmacy Experience & Access team to oversee Part D program operations, including coverage determinations, appeals, and CMS compliance. Manage audit readiness through mock audits, HPMS reporting, and data validation while optimizing PBM delegated programs for DUR, FWA, and utilization management. Serve as subject matter expert for redeterminations and implement process enhancements to strengthen efficiency and member experience. Provide supervision and coaching to pharmacists and support staff, ensuring adherence to clinical policies and Medicare Part D regulations.
Required Qualifications
- Graduate or Advanced Degree
- Pharm D
- Active Pharmacist License
- Demonstrated knowledge of and experience monitoring Medicare Part D regulations
Desired Qualifications
- Completion of a PGY1 and/or PGY2 residency or equivalent clinical practice experience
- 5+ years or more of managed care pharmacy experience
- equivalent experience in a managed care setting
- 1-2 years leadership/management experience
- Knowledge and experience with organizing quality improvement initiatives and presenting findings to leadership
- Demonstrated ability to manage multiple priorities simultaneously
- Strong organizational, time management, and project management capabilities
- Self-starter with a resourceful and innovative mindset
- Effective across cross-functional teams and collaborative environments
- Exceptional verbal, written, and interpersonal communication skills
- High commitment to professionalism and customer service
- Computer proficiency
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