Overview:
The Director of Pharmacy is responsible for supporting the AVP of Medical Cost Containment in the implementation, process improvement, and optimization of clinical programs. The Director of Pharmacy will be responsible for analytic measurement and improvement of medical management of their assigned programs. These programs may include pharmacy and other associated operational processes and interventions. This role will achieve outcomes by focusing on analytics, clinical operations, and development of new programs to support organizational vision, and cost savings. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust organization.
Responsibilities:
- Serve as a business owner for medical product management needs specific to pharmacy program and establishing key performance indicators, identifying opportunities, and driving business goals
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Manage a team of 8 pharmacists through a remote setting, overseeing a countrywide prior authorization program specific to workers compensation claims.
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Monitor, analyze, and trend clinical program data to assist in the development, implementation, and driving of key initiatives.
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Evaluate new and emerging regulations as they impact the program and problem solve for implementing change and producing outcomes
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Optimize clinical programs for nurse and adjuster efficiency, streamlined injured employee experience, and positive claim outcome
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Manage day-to-day issues with clinical program management interfacing with vendors and internal staff
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Identifies best practices and trends in the industry, participates in evaluating new and emerging technologies and treatments to determine possible incorporation into programs
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Participating in office managed care and clinical operational reviews
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Manages project development/enhancements through coordination with WC operations
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Keeps current with market trends and demands
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Performs other functionally related duties as assigned
Qualifications:
Required:
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PharmD. or RPH
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Experience with Workers Compensation insurance carrier setting or related industry
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Ability to lead team of pharmacists and any necessary process improvement efforts needed to improve organizational outcomes
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Demonstrated results in developing strategic plans and executing key initiatives
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Proficient in data evaluation and visualizations
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Excellent English communication skills, written and verbal, as well as strong analytic, documentation, and organizational skills
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Efficient with multitasking between projects
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Proficiency in all Microsoft Office products including Project, Word, Excel, PowerPoint, Visio, and SharePoint
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Ability to prepare and effectively communicate presentations, interpret/develop reports, metrics and improvement plans, and to interact collaboratively and work effectively with a multi-functional team and throughout the organization; foster an environment of shared responsibility and accountability
Preferred:
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2+ years of managing projects and/or vendor relationships
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2+ years of experience writing SQL queries, creating stored procedures, views, and functions
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2+ years of management experience preferred
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Project Management Office (PMO) experience
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Knowledge of workers' compensation laws and regulations, medical billing (ICD9/10, CPT, HCPCS)
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Experience with State and external accreditation managed care audits and with writing and implementing program level policy and procedures
The expected salary range for this role is $130,000-$155,000.
Please note that the salary information shown above is a general guideline only. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations.
This job description is designed to provide a general overview of the requirements of the job and does not entail a comprehensive listing of all activities, duties, or responsibilities that will be required in this position. AmTrust reserves the right to revise this job description at any time.
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What We Offer:
AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.
AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.
AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future.
