Pharmacy Operations Job Description

Pharmacy Operations Job Description

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Pharmacy operations provides support for the Medicare Team at meetings as a knowledge expert of the Medicare Part D formulary.

Pharmacy Operations Duties & Responsibilities

To write an effective pharmacy operations job description, begin by listing detailed duties, responsibilities and expectations. We have included pharmacy operations job description templates that you can modify and use.

Sample responsibilities for this position include:

Leads the effort to obtain and maintain certifications and accreditations including URAC, VIPPS, NCQA, and any others that may be required to meet business needs
Completes or oversees team on research projects assigned by management to assess compliance of future and existing business operations
Lead cross functional workgroups to include Product Management, Compliance and Operations representatives PBM attendees
Support the Medicare Part D formulary management process by keeping accurate records and performing all development, maintenance and monthly updates to pharmacy marketing materials, printed member formularies, benefit and formulary content on our website
Address Network Pharmacy questions that arise (Pending fees, delivery issues, excessive/insufficient inventory)
Assist in launch of new products/programs within Network Pharmacies, and collaborate with Programs, Clinics and Pharmacy on initiatives and new launches
Prepares and/or fills medication orders (oral, topical, ) under the supervision of a licensed pharmacist
Maintaining a positive environment for successful compliance with EEO/AAP objectives
Determining staffing requirement for the department
Working with supervisors to ensure understanding and adherence to the budget process

Pharmacy Operations Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Pharmacy Operations

List any licenses or certifications required by the position: PTCB, CPR, BLS, ACLS, PALS, BCPS, IV, ACPE, GOLD, BPS

Education for Pharmacy Operations

Typically a job would require a certain level of education.

Employers hiring for the pharmacy operations job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Master's Degree in Pharmacy, Business, Science, Education, Management, College of Pharmacy, School of Pharmacy, Graduate, MBA, Health Care

Skills for Pharmacy Operations

Desired skills for pharmacy operations include:

Company asset protection techniques
Medicare Part B and Part D coverage guidelines and payment methodologies
Excel
Medicare Part D
Practices
PBM
Billing and reimbursement rules
Business
Claims
Customer's business to develop optimal solutions

Desired experience for pharmacy operations includes:

Five – eight years of experience or Master’s degree and six to 10 years’ experience
Willingness to work a flexible schedule during peak times
Demonstrated ability to coordinate people and teams to project completion
Supports operations by coordinating between pharmacy services and other areas of the company as needed to ensure the health plan is meeting CMS requirements
Directs activities if service areas are changed or added
Facilitates and coordinates resources to support compliance/audit activities (federal and state site visits, surveys, reviews, ) and directs activities on corrective action plans

Pharmacy Operations Examples

1

Pharmacy Operations Job Description

Job Description Example
Our company is searching for experienced candidates for the position of pharmacy operations. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for pharmacy operations
  • Process pharmacy authorizations utilizing PBM real time on line claims adjudication software
  • Support Medicare Part D and understanding of CMS guidelines
  • Developing supervisors in areas of pharmacy operations, employee relations
  • Guides the Company’s development of rules, policies and processes to support compliant pharmacy services to clients
  • Supports processes to ensure federal and state regulations and program requirements are met and maintained
  • Manages any investigations related to noncompliance or alleged violations of federal/state statutes, policies and procedures
  • Oversees the development, implementation and maintenance of an effective compliance communication and training program
  • Proactively monitors, researches and advises on regulatory requirements to ensure company-wide compliance
  • Oversees and manages the acquisition/ maintenance of all required pharmacy licenses on a national level, including resident and non-resident pharmacy permits
  • Stays current with state board pharmacy regulations, supports the HIPAA compliance program
Qualifications for pharmacy operations
  • Maintains positive working relationships with constituent organizations (CMS)
  • Have earned a B.S
  • Tracks compliance with applicable laws and regulations, works with appropriate staff to ensure applicable laws and regulations are appropriately documented and works with the Pharmacist-in-Charge to ensure staff are trained on new requirements
  • Ensures adherence to federal and state privacy requirements and conducts mock audits and inspections to ensure compliance and preparedness for actual inspections by local, state, and federal authorities and accreditation agencies
  • Ensures review of all new and revised member materials, labels, and package for compliance to applicable laws and registrations
  • Demonstrated experience providing Senior Leadership Team level reporting
2

Pharmacy Operations Job Description

Job Description Example
Our company is hiring for a pharmacy operations. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for pharmacy operations
  • Communicate and implement innovative change and best practice standards for pharmacies
  • Resolve implementation and execution obstacles with appropriate partners
  • Working with the teams in the field, identify specific gap areas for operations and processes improvement
  • Implement and execute upon action plans to remedy identified problems
  • Provide communication to field and store level pharmacy leadership to ensure alignment with corporate strategies and execution requirements
  • Ensure all pharmacy initiatives and processes are rolled out effectively
  • Coordinate the resolution of system related problems with the appropriate partners
  • Partner with service vendors to ensure timely invoice compliance
  • Partner with service vendors to ensure maintenance is current on pharmacy machines such as blood pressure monitors and pharmacy robots
  • Handles licensing of pharmacies in Iowa, other states and ensure data is submitted to those states appropriately and accurately
Qualifications for pharmacy operations
  • Highly collaborative individual with ability to influence others and build strong professional relationships across departmental and segment boundaries at all levels of associates and leadership ranks
  • This position is full-time (40 hours per week) days no weekends
  • Bachelors of Science or Pharm D degree in Pharmacy from College of Pharmacy
  • Experience as a pharmacist in an acute-care hospital setting or general pharmacy practice residency preferred"
  • Current FL Pharmacist license or license eligible
  • Completion of a Bachelor of Science degree in Pharmacy or PharmD
3

Pharmacy Operations Job Description

Job Description Example
Our innovative and growing company is hiring for a pharmacy operations. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for pharmacy operations
  • Coordinate the daily operational activities of the pharmacy to provide for a well organized and efficient department
  • Manage of central pharmacy operations
  • Be resonsible for personnel management including supervision of technicians
  • Be responsible for technology management (Pyxis, drug packager)
  • Lead work flow and production efficiency
  • Manage drug procurement practice and operational components of drug shortages
  • Be resonnsible for the oversight of Controlled Substance program
  • Responsible for meeting regulatory requirements of operations (Joint Commission, Board of Pharmacy)
  • Lead yearly plan year implementation and ongoing program changes thru test plan development, validation and testing of pharmacy initiatives, reporting of results and collaboration with third party validation entities
  • Maintain and employ expert and current knowledge of CMS requirements for Part D plans as applied to pharmacy contracts, benefits plans, delivery systems, reimbursement systems, products, policies and procedures and lead implementation of operational changes
Qualifications for pharmacy operations
  • Three years of recent hospital pharmacy experience
  • New York State Pharmacy License or eligibility to obtain license within 3 months
  • Ability to develop, implement and lead all aspects of pharmacy operation
  • Ability to make decisions responsibility
  • Completion of hospital PGY2/ pharmacy specialty residency or fellowship Specialty BCPS certification
  • 8 – 12 years experience in an operations management role and people leadership with a focus on lean methodology and quality improvements preferred
4

Pharmacy Operations Job Description

Job Description Example
Our company is searching for experienced candidates for the position of pharmacy operations. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for pharmacy operations
  • Lead daily rejected claim review process and supervise analysts from data analysis and research thru to identification of trends and assessment of individual member impact
  • Oversee issue tracking from identification thru resolution including obtaining issue reports and impact analysis from responsible parties for submission to Medicare Compliance Committee
  • Provide Operational expertise to help shape strategic formulary and program management
  • Perform regular maintenance and updates to the utilization management documents supporting the CMS submission and approval process, implementation and testing to ensure compliance and accuracy
  • Provide formulary and pharmacy benefit support to sales associates and work with account reporting to analyze drug utilization trends and generate disruption reports for accounts as needed
  • Provide ongoing performance management and coaching to direct reports
  • Receive, process, and archive provider’s retail fax and phone authorization requests accurately using multiple computer systems against our Medical Policy Criteria
  • Analyze and interpret high level medical data and accurately data entry information according to NCQA guidelines
  • Receive, process, and archive Home Infusion Therapy and Utilization Management Medical requests accurately using MCPS/Express Path and other systems via fax or telephone
  • Communicate determinations to providers via incoming and outgoing telephone calls
Qualifications for pharmacy operations
  • Moderate relational database query skills preferred (e.g., Access)
  • 2 years experience of working in a hospital pharmacy department
  • Completion of a Pharmacy PGY-1 Practice Residency
  • Bachelor of Pharmacy or Pharm D from accredited universities
  • Proficient with all programs in MS Office
  • Experience involving process improvement, preferred
5

Pharmacy Operations Job Description

Job Description Example
Our growing company is looking for a pharmacy operations. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for pharmacy operations
  • Develop, implement and share best practices and quality initiatives with team and other business owners
  • Lead ongoing implementation and maintenance of clinically appropriate and cost effective programs to help control the escalating costs of pharmaceuticals and utilization rates across all lines of business
  • Manage Pharmacy Operations managers to develop and implement new workflows and improve current workflows to meet business requirements
  • Support new clinical program implementation
  • Serve as a liaison to Member Services and other internal clients for real-time support on pharmacy benefit interpretation, Medical Policy interpretation, and plan design interpretation
  • Coordinate staffing schedule to provide volume-based staffing and satisfy the needs of the customer
  • Submit monthly expense variance justifications and proposes action plan as needed
  • Submit capital requests based on needs analysis and long range planning as needed
  • Hire, train, counsel, discipline, transfer, evaluate, and promote direct reporting staff positions
  • Investigate, evaluate, and resolve concerns of customers and keep the next level of management informed of significant developments
Qualifications for pharmacy operations
  • Will have a Master's degree, MBA or MHA
  • Has completed an Advanced Pharmacy Practice Residency (PGY-2)
  • Has Florida Consultant Pharmacist License
  • Is a Board Certified Oncology Pharmacist
  • Minimum of five years of experience in pharmacy leadership
  • Requires extensive knowledge and experience in finance

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