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Pharmacy Reimbursement Manager: Administration - OP Pharmacy

Company: Memorial Healthcare System
Location: Fort Lauderdale
Posted on: May 3, 2021

Job Description:


Responsible for implementing and managing the pharmacy patient assistance program system-wide. Oversees evaluation of outpatient infusion medication coverage.

Detailed responsibilities:

  • Plans, develops, organizes, and manages pharmacy patient assistance activities system-wide to meet program metrics and targeted savings. Directly supervises patient assistance program staff, with the responsibility of hiring, training, and evaluating employee performance
  • Monitors, tracks and reports all patient assistance program efforts and outcomes. Ensures appropriate tracking of patient assistance program applications, enrollments, and medication cost savings reporting
  • Responsible for keeping up, implementing, and communicating program updates to the patient assistance team, and other departments as needed. Supports District Formulary efforts in evaluating patient assistance and reimbursement impact for formulary reviews
  • Implements and oversees outpatient infusion drug benefit investigation, including site of care coverage, prior authorization, benefit investigation, and out of pocket expense
  • Monitors for system-wide growth opportunities and performance improvement processes. Engages technology resources to develop and implement workflow enhancement and data collection/reporting
  • Collaborates with patient financial services to expand resource stewardship related to pharmaceutical patient assistance and outpatient infusion medication coverage

Competencies and skills:


  • STANDARDS OF BEHAVIOR: Acts in a manner that supports the standards of communication, respect, privacy, and teamwork by demonstrating a commitment to professional and ethical conduct.
  • CUSTOMER SERVICE: Demonstrates commitment to service excellence by promptly addressing internal/external customer issues/requests, resolving concerns while maintaining a professional image and behavior to build and enhance the patient/family/customer experience.
  • ACCOUNTABILITY: Accepts ownership of job roles and specific assignments/goals; works independently, takes responsibility for own actions; admits mistakes and judgment errors; and accepts constructive feedback. Connects personal work results to the accomplishment of team and organizational goals.
  • RESPONDING TO CHANGE: Accepts change and adapts in a positive and productive manner; handles unexpected situations and changes in direction calmly and with confidence. Views new assignments and job responsibilities as an opportunity for growth.
  • MANAGEMENT OF DRUG THERAPY PROTOCOLS: Designs and manages drug therapy protocols.
  • ANALYSIS AND DECISION MAKING: Uses decision making processes and tools to analyze situations and make effective decisions.
  • DEVELOPING RELATIONSHIPS: Builds positive and productive business relationships with individuals and groups.
  • PROJECT MANAGEMENT: Leads project teams and implements project plans in accordance with established goals and measures.
  • PATIENT AND FAMILY CENTERED CARE: "Provides Patient and Family Centered Care to patients, families, visitors and internal customers"
  • CLINICAL POLICIES AND STANDARDS: Applies knowledge of clinical standards, policies, and procedures relevant to function and organization.



  • Associates



  • Registered Pharmacy Technician - FL

Education equivalent experience:


  • Other information:

Complexity of Work: This role requires critical thinking skills, effective communication, decisive judgment, and the ability to work with minimal supervision. The incumbent must be able to work in a stressful environment and take appropriate action when required.

Required Work Experience: 1 year of supervisor experience and 3 years of pharmacy experience

Organizational Profile:

Since its inception in 1953, Memorial Healthcare System has been a leader in providing high-quality healthcare services to South Florida residents. Today, it is one of the largest public healthcare systems in the nation with over 14,000 team members and highly regarded for its exceptional patient- and family-centered care. Memorial's patient, physician and employee satisfaction rates are some of the most admired in the country, and the system is recognized as a national leader in quality healthcare.

Memorial has a reputation as one of Florida's leading healthcare systems and is supported by a distinguished medical staff. In fact, the vast majority of physicians are board certified or board qualified in their specialties and have been trained at many of the nation's finest medical schools and hospitals. Because of its distinguished medical staff and services, Memorial draws patients from South Florida and beyond.

Many prestigious healthcare awards have been earned by Memorial Healthcare System and its facilities. The accolades include: Modern Healthcare magazine's Best Places to Work in Healthcare, Florida Trend magazine's Best Companies to Work for in Florida, 100 Top Hospitals, Consumer Choice Award, Best-Run Hospital, Best Nursing Staff, Best Pediatric Hospital and Best Maternity Hospital.

Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.

Keywords: Memorial Healthcare System, Fort Lauderdale , Pharmacy Reimbursement Manager: Administration - OP Pharmacy, Other , Fort Lauderdale, Florida

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