Job Description

Job Title: Coordinator, Pharmacy Quality
Job ID: 636876
Status: Full-Time
Regular/Temporary: Regular
Hours: 8:30 a.m. - 5:00 p.m.
Shift: Day Job
Facility: UPMC Health Plan
Department: PHARMACY SRVCS
Location: 600 Grant St, Pittsburgh PA 15219

Description

Are you currently a licensed Pharmacist in Pennsylvania? Do you have at least three years' experience in a progressively more responsible managed care pharmacy setting? Are you someone that takes ownership over your work and can handle multiple projects at once? If so, UPMC may have the perfect fit for you!

Responsibilities:

  • Actively participate in professional organizations so as to bring recognition to the Health Plan
  • Analyze resource utilization in order to maximize efficiency and effectiveness of pharmacy quality programs
  • Assists in the development and management of a strategic plan for pharmacy quality programs. Through data analysis and drug utilization evaluations, assess current quality strategy and opportunities for development of programs in current and new therapeutic target areas.
  • Assists to operationalize and maintain processes for formulary management and maintenance, including benefit configuration, formulary submissions, and the communication of formulary changes as needed
  • Coordinate with internal and external stakeholders to monitor the success of Pharmacy initiated quality programs through reporting and outcomes analysis
  • Critically review of medication based prior authorization requests for approval/denial against standard criteria as needed
  • Interface with external partners, providers, clients, or customers to maximize opportunities around HEDIS and Star measures as well as other quality initiatives
  • Mentor students and residents as a preceptor
  • Monitor vendor relationships as part of the pharmacy quality strategy
  • Operationally manage internal pharmacy initiatives that focus on quality and member/provider satisfaction
  • Participate in committees relevant to strategic issues impacting quality
  • Regularly review and analyze department reporting to ensure compliance with the business plan and Health Plan processes and strategy
  • Responsible for ensuring timely and accurate regulatory reporting and compliance with regulatory and accreditation requirements if applicable
  • Support pharmacy network focused quality programs
  • Support provider focused pharmacy quality programs (P4P, shared savings)

Qualifications

  • Doctorate in Pharmacy (PharmD)
  • 3 years' experience in a progressively more responsible managed care pharmacy setting
  • Experience in pharmacy quality management, NCQA/HEDIS, Stars, insurance, managed care preferred and be knowledgeable in therapeutic interventions and other cost containment programs
  • Effective communication skills, both written and oral Must have strong analytical ability and organizational skills
  • Computer literacy for pharmacy programming, word processing, data management
  • Assessment of job related skills and competency will be reviewed annually via daily functioning, job-related documentation, department based competency programs, and continuing education activities

Licensure, Certifications, and Clearances:
Current licensure or licensure eligibility to practice pharmacy in the Commonwealth of PA Continuing Education requirements met each bi-annual cycle for re-licensure, as evident by obtaining a minimum of 30 hours of continuing education every 2 years in structured pharmaceutical education as necessary by the state board

 

  • Pharmacist


UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $43.60 to $74.06

Union Position: No

Apply Current Employee?

UPMC VALUES

At UPMC, our shared goal is to create a cohesive, positive, experience for our employees, patients, health plan members, and community. If you too are driven by these values, you may be a great fit at UPMC!

QUALITY & SAFETY
DIGNITY & RESPECT
CARING & LISTENING
RESPONSIBILITY & INTEGRITY
EXCELLENCE & INNOVATION

UPMC provides a total rewards package that can help you achieve the goals you have for your career and your personal life. Whether you want to learn a new skill through a training course, reach personal health and wellness targets, become more involved in your community, or follow a career path that provides you with the right experience to be successful, UPMC can help you get to where you want to be.


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