Mgr, Pharmacy Benefits & Quality

Manage the activities of the Pharmacy Quality Auditors in the Pharmacy Benefit Relations Department.


Reports to: Director, Pharmacy

Position Location: George Road Tampa, FL 33634

Essential Functions:
  • Responsible for the performance management processes for direct reports including coaching, counseling, providing feedback, career planning, goal setting, and performance assessment.
  • Manages process improvement initiatives, seeking root cause and developing appropriate corrective action.
  • Leads in developing and providing direction and vision of the Pharmacy Quality Auditor team in the Pharmacy Benefit Relations Department.
  • Establishes objectives, goals and performance measures for the function being managed.
  • Develops, recommends, and implements Quality related process improvements to improve efficiencies and services provided. Responsible for tracking and reporting performance to Pharmacy leadership.
  • Creates, maintains and updates work flow systems, processes and documentation.
  • Responds to internal inquiries from Pharmacy partners including requests for appeals.
  • Assists in developing short range plans for overall departmental activities.
  • May oversee the implementation of programs and strategies.
  • May act in liaison capacity with other areas and business units.
  • May make recommendations on matters of policy and approve changes in area of expertise.
  • Partners with the Pharmacy Operations teams in updating QA processes, procedures, and documentation, as well as, providing coaching when requested.
  • Supports the Pharmacy Benefit Relations leadership team on a wide array of ad hoc tasks relating to Pharmacy Operations, QA, and the PBM.
  • Participates in special projects as needed.
  • Other duties as assigned.
Additional Responsibilities:
    Candidate Education:
    • Required A Bachelor's Degree in a related field
    • Required or equivalent work experience
    Candidate Experience:
    • Required 5 years of experience in Pharmacy Technician or similar position
    • Required 3 years of experience in a lead role or supervising others
    • Preferred Other health care delivery / managed care industry experience
    • Preferred Other Quality Assurance experience
    Candidate Skills:
    • Intermediate Ability to communicate and make recommendations to upper management
    • Advanced Ability to effectively present information and respond to questions from peers and management
    • Advanced Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions
    • Intermediate Ability to implement process improvements
    • Intermediate Demonstrated leadership skills
    • Advanced Demonstrated written communication skills
    • Advanced Demonstrated interpersonal/verbal communication skills
    • Intermediate Demonstrated time management and priority setting skills
    Licenses and Certifications:
    A license in one of the following is required:
    • Preferred Certified Pharmacy Technician (CPhT)
    • Preferred Other Registered Pharmacy Technician
    Technical Skills:
    • Required Intermediate Microsoft Outlook
    • Required Intermediate Microsoft Word
    • Required Intermediate Microsoft Excel

      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.