Manager, State Pharmacy

Location: Miami, FL (Covers South Florida and Southwest Florida)
Department: Pharmacy
Reports to: Director, State Pharmacy
Provides clinical pharmacy direction for the health plan including, but not limited to Disease Management, Pharmacy, Utilization and Quality Management. Provides drug utilization review and intervention while targeting high utilizing physicians and reviewing prescribing patterns including non-preferred drugs and quality indicators. Makes recommendations on prescribing practices to reduce costs. Prepares drug review evaluations for the Pharmacy and Therapeutic Committee and provides in-service education to the nursing staff, pharmacy technicians, pharmacists and medical directors. Assists in the development of goals and objectives for the clinical pharmacy programs and serve as a resource for drug information. Reviews prior authorizations and supports the efforts of the pharmacy call center where applicable.
Essential Functions:
  • Reviews prescribing practices of high utilizing physicians and intervene as needed. Provides drug information on pharmacy expenses and recommends changes in prescribing practices to improve quality and lower costs.
  • Supports and reviews the Drug Evaluation Reviews received in the pharmacy call center where applicable.
  • Provides detailed claim analysis for over and under utilization.
  • Reviews pharmacy data to look for savings opportunities.
  • Provides clinical pharmacy support for Pharmacy, Disease Management programs, Quality and Utilization Management.
  • Provides drug evaluation reviews for the P&T Committee.
  • Provides in service education to staff.
  • Provides drug utilization reviews as needed.
  • Performs special projects as needed.
Education: A Bachelor's in Pharmacy. A Pharm D preferred
Experience: 3 years experience as a certified pharmacist with exposure to managed care
Licenses/Certifications: Licensed pharmacist in state of operation. Licensed consultant in state of operation.
Special Skills (e.g. 2nd language):
Strong oral and written communication skills.
Ability to use pharmaceutical and medical reference, literature to provide drug information to the health plan.
Ability to evaluate information from both oral and written sources and develops clear, concise and crisp reports.
Excellent interpersonal skills with the ability to influence others.
Ability to evaluate the financial impact of drug products.

About us
Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored managed care services through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans to families, children, seniors and individuals with complex medical needs. WellCare is a Fortune 500 company, and in 2018, was recognized as a Fortune "World's Most Admired Company", ranking in the top five among the health insurance and managed care industry-a testament to the hard work and dedication of the company's nearly 9,000 associates who each day live WellCare's values and deliver on its mission to help its members live better, healthier lives. The company serves approximately 4.4 million members nationwide as of Dec. 31, 2017. For more information about WellCare, please visit the company's website at EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.