AMVETS Jobs

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.