Anthem, Inc. Director of Clinical Pharmacy Strategies in Hialeah, Florida
SHIFT: Day Job
Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health care companies and a Fortune Top 50 Company.
Responsible for leading the development, implementation and evaluation of clinical interventions and cost of care management strategies for all customer business segments.
Primary duties may include, but are not limited to:
Establishes and executes clinical intervention programs.
Evaluates and implements clinical quality and cost of care programs.
Manages clinical and economic rule sets used in the pharmacy care note communications.
Supports enterprise accreditation process.
Collaborates with the Care Management team to improve medication compliance and reduce hospital re-admissions.
Provides Request for Proposal (RFP) support and assists with business growth and client retention.
Manages budget and increases clinical product revenue.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against Covid-19. All offers of employment are conditioned on completion of a background check, including COVID-19 vaccination verification. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws.
Requires a PharmD, RPh or MPh and minimum of 5 years of managed care experience; or any combination of education and experience, which would provide an equivalent background.
Current pharmacist license required.
Requires BS in Pharmacy. PharmD preferred.
Specific knowledge of OIG, ERISA, HIPAA and regulatory environment, DSM / HEDIS / Quality Improvement / Clinical Interventions program development and oversight strongly preferred.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.