Director Of Clinical Pharmacy

Director of Clinical Pharmacy, Medicare Advantage

CommuniCare Advantage is a Medicare Advantage plan created to coordinate care and organize meaningful health benefits to help our members thrive. We are a provider-owned health plan based outside of Cincinnati, Ohio, and covering selected counties in Indiana, Maryland, and Ohio. Our specialized and individual Medicare Advantage plans are designed to meet the health needs of those who manage chronic health conditions, live in a nursing facility, individuals 65 and older or that qualify for Medicare.

THE ROLE

We are seeking a highly skilled and motivated individual to join our team as the Director of Clinical Pharmacyat CommuniCare Advantage. This leadership role provides strategic, tactical, and operational leadership in creating evidence-based pharmacy care programs instilling and reinforcing CommuniCare Advantage’s mission and advancing the role of a health plan in providing the right care.

JOB RESPONSIBILITIES

• Clinical Pharmacy Program Development: As the Director, you will be responsible for designing, implementing, managing, and measuring the development of comprehensive Clinical Pharmacy programs. This includes focusing on optimizing medication management, ensuring appropriate and effective medication utilization, and improving health outcomes for our members.
• Multi-Disciplinary Collaboration: You will actively engage as a leader for the I-SNP (Institutional Special Needs Plan) and collaborate with physicians, nurse practitioners, care managers, and behavioral therapists to ensure a patient-centered approach to medication management. Your expertise will contribute to enhancing overall care coordination and treatment outcomes.
• Team Management: You will lead and mentor a team of Clinical pharmacists. Your guidance will be vital in fostering a collaborative and innovative environment to achieve program objectives.
• Utilization Management: Collaborate with cross-functional teams to identify utilization trends and lead specific interventions to manage medical and pharmacy drug utilization and ensure cost-effective and evidence-based medication practices. Your expertise will contribute to maintaining the highest quality of care while managing expenses.
• Stars Performance: enhance stars performance related to medication adherence and pharmacy measures.
• Compliance and Regulatory Oversight: Maintain a thorough understanding of Medicare Advantage regulations, guidelines, and standards related to pharmacy services. Ensure that all Clinical Pharmacy program activities are compliant with regulatory requirements.
• Data Analysis and Reporting: Utilize data analytics to evaluate the effectiveness of the Clinical Pharmacy program and identify areas for improvement. Regularly report on program outcomes and collaborate with stakeholders to optimize results.
• Stakeholder Collaboration: Foster positive relationships with internal and external stakeholders, including providers, healthcare partners, and pharmacy benefit managers. Collaborate to enhance patient care and overall health plan performance.
• Continuous Improvement: Promote a culture of continuous improvement and innovation within the Clinical Pharmacy department. Stay abreast of industry trends and best practices to maintain the organization's competitive edge.
• Actively support the achievement of CommuniCare Advantage’s Vision and Goals.
• Other duties as assigned.

QUALIFICATIONS/EXPERIENCE REQUIREMENTS

• Doctor of Pharmacy (PharmD) degree from an accredited institution required.
• Minimum 4 years of experience in Clinical Pharmacy leadership roles, preferably within a Medicare Advantage, PBM, PBP development
• Strong understanding of Medicare Advantage regulations and pharmacy-related quality measures (Stars ratings).
• Proven track record of developing and implementing successful Clinical Pharmacy programs.
• Excellent leadership, communication, and interpersonal skills.
• Proficiency in data analysis and reporting tools.
• Ability to adapt to a fast-paced and dynamic healthcare environment.

WHAT WE OFFER

• Position will be mostly onsite with in office days on Tuesday & Wednesday each week
• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO)
• Ten paid holidays per year, plus 1 additional floating holiday
• Excellent 401(k) Retirement Saving Plan with employer match and contribution
• Robust employee recognition program
• Tuition reimbursement
• An opportunity to become part of a team that makes a difference to our members and our community every day!

ABOUT US

CommuniCare Advantage is part of the CommuniCare Family of Companies, which includes CommuniCare Health. As a family-owned company, CommuniCare Health has grown to become one of the nation’s largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACHs). Our CommuniCare Medicare Advantage and special needs plans are another way we care for our residents and communities.