What you’ll do
In a few words…
Get ready to lead the orchestra! The Director of Clinical Services, like the director of any musical group, has a dynamic role that requires comprehensive understanding and knowledge of various musical instruments (pharmaceutical, biomedical, socio-behavioral, and clinical sciences). With your internal metronome and musical harmony, you will oversee and execute innovative pharmacy clinical programs (new experimental musical compositions) to improve health outcomes, enhance quality, and manage costs (After all, going to concerts should be affordable. Otherwise, whom will you play for?) You will provide vision and leadership to the Clinical Services Department (the orchestra), to strategically develop new clinical programs, ensure the quality of services provided, and guarantee client satisfaction. As our Clinical Services Director, you will work with clients (the public for which you perform should be engaged) and cross-functionally within the organization (various sections of the orchestra) to implement and execute effective end-to-end clinical programs (beautiful music) and evaluate and analyze data and outcomes to identify opportunities for improvement. We aim for angelic harmonies that heal the body and soul.
The fundamentals for the job…
- In this role you will work directly with the Clinical Outreach Manager, Clinical Programs Manager, and the Clinical Support Manager to assess and improve productivity levels in the Department
- Provide management for daily operations of the clinical department
- Plan, organize, develop, implement, and interpret the company’s clinical programs, goals, objectives, and necessary policies and procedures (Twiddling your fingers like Mr. Burns is optional.)
- Oversee the development and implementation of Clinical Programs, evaluate program performance, recommend changes, and ensure successful implementation of changes (Because change is the only constant.)
- Use outcome data and KPIs to manage staff and program performance
- Oversee the Clinical Programs and Clinical Services Support (i.e. Coverage Determinations) Units to ensure that operational goals are met, including, but not limited to CMR completion rates and other commitments and promises made to clients
- Oversee Medicare 5-Star quality measures and ensure clients surpass or maintain previous ratings
- Engage in periodic consultation with practitioners in the field, such as providers and members of the Pharmacy and Therapeutics Committee (P&T)
- Prepare periodic reports for management, as necessary or requested, to track strategic goal accomplishment (Charts are your friend. Embrace them!)
- Be accountable for decisions made by qualified clinicians, which affect consumers (Not a problem. This is in your DNA!)
- Monitor trends and make informed decisions regarding service provisions
- Coach, mentor, and develop staff, including overseeing new employee onboarding and provide growth and development to direct reports (One cannot be a leader without a team to lead.)
- Work with People Operation’s staff to interview, select, and hire new employees (Team building is a beautiful thing!)
- Evaluate performance and employee discipline
- Manage concerns relating to coverage, productivity, skills, and workload expectations
- Provide administrative support, supervision, and consultation to support and broaden staff skill levels
- Strategically evaluate and identify business needs related to clinical programs to develop and implement solutions (Your natural inclination towards problem solving will be so happy!)
- Support the Business Development Department in RFPs and development of proposals related to services provided in the Clinical Services Department
- Work with cross-functional teams to ensure client satisfaction (Client Engagement Team), compliance with laws and regulations (Compliance Department), accurate billing of clinical services (Finance Department), and exceptional delivery of clinical programs’ modules and enhancements (Product Strategy and IT), among others
- Support and oversee medication safety-related activities, such as Abarca’s Medication Error Identifications and Reduction Program, Consumer Safety Committee, drug recalls and shortages, drug safety notifications.
- Oversee Abarca’s strategy to educate and inform providers in pertinent clinical topics (e.g. safety notifications, pharmacy newsletters, Academic Detailing, etc.), such as the Pharmacy Network and Prescribers.
- Interact regularly with clients
- Monitor compliance with laws and regulations, including support of audit processes related to the Clinical Services Department functions
- Develop policies and procedures to ensure quality services for clients and accountability for staff
- Identify and execute process improvement opportunities that will enhance quality of work
- Assist with presentations to clients and potential clients regarding Clinical Services
- Understand and remain informed of utilization and quality management techniques, drug trends, and issues in Medicare to effectively and cost efficiently develop and implement strategies to improve health outcomes.
- Other projects or duties as needed (Because being multi-faceted is always a good thing!)
What you’re made of
The bold requirements…
- Doctoral Degree in Pharmacy (required)
- Current/Active Pharmacy License
- 5+ years of Clinical experience. PBM experience would make us very happy!
- Post-graduate clinical experience in patient care
- We’ll stamp your resume with a big STAR if you have Board certification (if the person is an M.D. or D.O.)!
- We’ll give you special points for knowledge or experience with PBM clinical operations and Medicare Part D.
- More bonus and special stickers for experience with MTM or other clinical programs!
- Computer proficiency. Your Microsoft Office Suite skills (Word, Excel, PowerPoint, and Outlook) are Jedi Master level and you surf (the internet) better than Kelly Slater.
- You should have previous clinical knowledge (a given) and a focus on customer service (Is there any other kind of focus?), be an awesome context provider and explainer of scenarios and situations (because you WILL be giving presentations), adjustable like a once-size belt, and have such keen attention to detail that it borders on a clinical disorder that we will appreciate.
- Must be able to communicate effectively (read, write, speak, curse, text, Google stuff, tweet, etc.) in English and Spanish.
That something extra we´d love to see…
- Responsible: You’re one of the most, if not THE most reliable person in the room. You own up to what you say and do, and correct things when you make mistakes. Honesty and loyalty are your most prized assets.
- Strategic: You’ve played every strategy game out there. Your mother claims you were born with a chessboard instead of a placenta attached to your umbilical cord and this could well be true. You’re always 3 steps ahead of the game quickly spotting relevant patterns and issues.
- Driven: Your juggling skills are OP and you never miss a deadline. You measure your progress against everyone else’s and strive to win at everything. Your legs could be dead halfway through a marathon and you would still finish the race because not getting there is simply NOT an option.
- Fixer of Problems and Master Solution seeker: Let’s just admit you like problems, but not because you’re some sort of drama nerd, you just love SOLVING problems in comprehensive ways that consider both internal and external needs. Once you find the root of a problem, you won’t hesitate to yank it out.
- Detailed: You notice everything, every little thing; and you rarely forget any of it. Your attention to detail borders on photographic and your spirit animal is a hawk. If anything changes, you notice.
The above description is not intended to limit the scope of the job or to exclude other duties not mentioned. It is absolutely not a final set of specifications for the position. It’s simply meant to give readers an idea of what the role entails.
Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of gender, race/ethnicity, gender identity, sexual orientation, protected veteran status, disability, or other protected group status.