Bilingual Clinical Operations Pharmacist
San Diego, CA - USA
Job Summary
Pay scale information is not necessarily reflective of actual compensation that may be earned nor a promise of any specific pay for any selected candidate or employee which is always dependent on actual experience education qualifications and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.
This position is not eligible for Sponsorship.
MedImpact Healthcare Systems Inc. is looking for extraordinary people to join our team!
Why join MedImpact Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity high performance and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.
At MedImpact we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products systems and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction service cost and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!
* The ideal candidate is bilingual with proficiency in English and Spanish *
The Bilingual Clinical Operations Pharmacist provides analytic/technical support to optimize the clinical quality and cost-effectiveness of drug and medical therapy as applicable for client plan sponsors and their members. Focuses on rational management of drug utilization by employing analytical tools and an evidence-based approach to achieve lower net cost better health outcomes and higher levels of satisfaction for plan sponsors and their members. The role manages operational aspects of clinical operations strategic initiatives projects and/or programs. This position focuses on supporting analytic technical and operational aspects of clinical management. The role collaborates across the organization. The role relies on data and performance indicators as well as experience and judgment to identify and promote performance improvement opportunities which attain the aligned goals of MedImpact and assigned clients.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
- Manages contributes and assists in current priority projects programs or initiatives as defined by supervisor. Provides clinical subject matter expertise and combines with business operations knowledge to ensure clinical and business appropriateness and success;
- Assists with related analytic needs to support recommendations being considered by assigned clients that align with both the clients and MedImpacts mutual goals of lower net costs and high clinical quality. The strategic recommendations may include: benefit design and formulary analysis and suggestions provision of clinical drug information client P&T support and participation recommendations for rational drug formulary positioning on-line system edits and restrictions on-going clinical product evaluations and recommendations regarding client pharmacy benefit utilization and performance trends;
- Supports clinical consultative services in accordance with contracted clinical services. The role is an integral part of designing developing and driving the clinical components of their assigned account teams strategic and financial goals. Ongoing focus will be centered on using a variety of analytical tools and clinical resources to identify opportunities which simultaneously improve the plan sponsors quality-focused and financial performance metrics;
- Supports analytics necessary for MedImpacts evidence-based interventions and communication programs to clients. Provides documentation of recommendations for clinically appropriate and financially beneficial clinical initiatives (e.g. lower net cost generic programs QA programs clinical and specialty programs and applicable rebate management);
- Coordinates clinical utilization analyses in collaboration with key stakeholders to support presentations to clients. Ensures timely and accurate review of plan data according to policy with appropriate intervention recommendations;
- Supports implements and maintains DUE DUR and QI programs to meet plan HEDIS and NCQA guidelines;
- Coordinates clinical support of Drug Formulary and Preferred Drug Lists during plan sponsors implementation and maintenance of business in collaboration with the Clinical Program Manager (Client Team);
- Supports recommended clinically appropriate initiatives to optimize the value of MedImpacts rebate administration program for clients while delivering on the lower net cost goal;
- Supports MedImpact P&T Committee quarterly meetings and weekly MediSpan drug updates.
Supervisory Responsibilities
No supervisory responsibilities
Client Responsibilities
This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.
Qualifications
To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience
PharmD and 3 years experience or equivalent combination of education and experience and 1 year of SME in respective areas
Computer Skills
To perform this job successfully an individual should have knowledge of Microsoft Office Suite and a proficient knowledge of Access Excel and relational databases.
Certificates Licenses Registrations
Valid Registered Pharmacist in the State of California or equivalent state.
Other Skills and Abilities
- Must be fluent in Spanish (speaking reading and writing)
- Analytical skills with Health Informatics experience preferred.
- Part D experience required
- Advanced Excel skills required
- Other technical skills preferred (Access SQL or Python)
- Experience working with PBM or health plans.
- Experience in promoting disease management and/or drug cost management programs preferred.
Reasoning Ability
- Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
- Ability to interpret a variety of instructions furnished in written oral diagram or schedule form.
Mathematical Skills
- Ability to apply concepts such as fractions percentages ratios and proportions to practical situations.
- Ability to add subtract multiply and divide in all units of measure using whole numbers common fractions and decimals. Ability to compute rate ratio and percent and to draw and interpret bar graphs.
Language Skills
- Ability to read analyze and interpret general business periodicals professional journals technical procedures or governmental regulations.
- Ability to write reports business correspondence and procedure manuals.
- Ability to effectively present information to top management public groups and/or boards of directors.
Competencies To perform the job successfully an individual should demonstrate the following competencies:
Composure
Decision Quality
Organizational Agility
Problem Solving
Customer Focus
Drive for Results
Peer Relations
Time Management
Dealing with Ambiguity
Learning on the Fly
Political Savvy
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this Job the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger handle or feel and reach with hands and arms. Visual acruity to 20 inches. The employee must occasionally lift and/or move up to 25 pounds.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate (examples: business office with computers and printers light traffic).
Work Location
This position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees colleagues clients or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.
Working Hours
This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and reasonably meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights at weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm.
Travel
This position may require domestic and international travel up to 10%. A valid passport and ability to leave the United States is required.
Medical / Dental / Vision / Wellness Programs
Paid Time Off / Company Paid Holidays
Incentive Compensation
401K with Company match
Life and Disability Insurance
Tuition Reimbursement
Employee Referral Bonus
To explore all that MedImpact has to offer and the greatness you can bring to our teams please submit your resume to is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego California. Our solutions and services positively influence healthcare outcomes and expenditures improving the position of our clients in the market. MedImpact offers high-value solutions to payers providers and consumers of healthcare in the U.S. and foreign markets.
To perform this job successfully the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge skill and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities duties and skills required of personnel so classified.
Required Experience:
IC
About Company
MedImpact Healthcare Systems fills the prescription for keeping its customers' bottom line in healthy condition. The company provides and manages prescription benefit programs for self-insured employers, health plans, unions, insurers, third-party administrators and others, covering s ... View more