REPORTS TO: Chief Operating Officer
Under the supervision of the Chief Operating Officer, the Pharmacy Business Operations Manager provides strategic, direct and indirect administrative, technical, operational, and 340B oversight for the pharmacy services at Unity Health Care Inc.
MAJOR DUTIES/ESSENTIAL FUNCTIONS
· Oversees pharmacy operations across the organization, both contracted and operations by the organization to provide timely and comprehensive pharmaceutical care services to the patients.
· Analyzes financial performance and areas of risk and compliance to identify opportunities for improvement.
· Strategically plans for pharmacy growth and maximizes revenue generation.
· Reviews prescribing practices and provides authoritative advice to clinical staff, physicians, dentist, and other providers.
· Works closely with Nursing, Medical Staff, and the Health Center Directors to address issues related to the provision of pharmaceutical services to patients throughout Unity Health Care Organization.
· Participates in assessing pharmacy software, hardware, and acquisitions.
· Participates in all pharmacy related programs, which includes OSHA, Infection Control Quality Improvement Programs, and Safety and Emergency Preparedness.
· Assists in the interviewing, hiring of any new Unity pharmacy staff and in conducting performance reviews and competency assessments of all the pharmacy staff in the clinic setting.
· Assists the Chief of Pharmacy in effecting staff disciplinary/corrective actions as appropriate.
· Provides clinical pharmacy function and administrative supervision to the DOC pharmacy operations when necessary.
· Oversees 340B Program Coordination and liaison for all 340B-related matters.
· Provides expertise on 340B and serves as the institutional "compliance expert or authority" regarding program details, policies, and procedures of the virtual inventory processes required for mixed-use areas, as necessary.
· Actively engages with senior leadership and participates in decision-making processes related to pharmacy and 340B; Develops and maintains internal relationships (accounting, legal, national) and external relationships (wholesalers, manufacturers, contract pharmacies, split-billing software vendors, employee benefit pharmacy benefits managers (PBMs), and third-party administrator (TPA) vendors) as needed.
· Acts as a liaison to the department of pharmacy and regional facilities as well as with the organization's purchasing office.
· Ensures that policies and procedures are developed and implemented according to organizational, regional, national, state, and federal requirements and guidelines and are approved by the institution's risk management and compliance department.
· Develops and oversees a regular compliance audit program; Periodically performs spot audits or compliance assessments in specific areas and specific products to ensure that the CDM is accurate, charges are coming across accurately, and the utilization numbers are translating accurately into report for 340B reorders; Conducts and/or coordinates an annual audit of all contract pharmacies. Documents results and follow- up on any findings.
· Contributes processes and materials to promote programs or support the goals of the department.
· Develops knowledge and maintains awareness of current regulations, trends, and issues pertaining to the 340B Program and keeps abreast of trends and issues pertaining to the program and related applications.
· Responsible for ensuring the annual HRSA recertification is completed within the allowable period.
· Responsible for ensuring that the HRSA 340B OPAIS is accurate for all organization entities.
· Responsible for ensuring registration of any new child site within the allowable period.
· Responsible for managing and troubleshooting pharmacy billing issues and ensuring that adequate systems checks are reviewed to prevent billing issues.
· Monitors utilization records and 340B purchasing accounts to ensure that software or tools are working properly and accurately, performing audits or compliance assessments internally as needed; coordinates external compliance assessments with outside firms, where appropriate, to validate internal processes.
· Conducts monthly audits of all 340B-eligible locations to verify adherence with the 340B Program guidelines and policies.
· Serves as the point person and coordinator for all pharmacy audits.
· Maintains a current state of "audit readiness."
· Works with medical auditors on third-party payer audits to ensure coordination of efforts and maximum collection.
· Provides oversight for all audits performed by independent external auditors.
· Reviews and negotiates any new 340B contracts.
· Evaluates all current and future contract pharmacy opportunities, including contract language, fee structure, data setup, and internal and independent external auditing.
· Assesses opportunities for cost savings and business improvements in 340B contract pharmacy utilization.
· Assesses opportunities for cost savings and system improvements to yield higher compliance.
· Oversees the 340B contract pharmacy-marketing program to attract and retain qualified retail pharmacy contracts and serve eligible patients.
· Maintains 340B split-billing software integrity and reviews applicable reports to identify areas for improvement.
· Works with outpatient pharmacy management and pharmacy informatics teams to ensure that the organization's clinical information system is coordinated and integrated into the work with the 340B Program. This shall include the electronic interfaces between the EMR and the virtual accumulator and any interfaces between the organization and contract pharmacy providers and/or administrators.
· Ensures split-billing software integrity and reviews applicable reports for areas of improvement.
· Performs other related duties and responsibilities as assigned.
· Bachelor's degree in pharmacy from an accredited collage of pharmacy.
· Minimum of five years of pharmacy practice experience and Management Training or Equivalent Managerial Experience required.
· Licensed Pharmacist pursuant to Title 2 Chapter 6 of the DC Code to provide Pharmaceutical Services in District of Columbia.
KNOWLEDGE & EXPEREINCE REQUIRED BY THE POSITION
· Extensive knowledge of the physical and chemical properties of drugs.
· Thorough knowledge of Federal and DC Government regulations and guidelines pertaining to pharmacy and as they relate specifically to ordering, storage, dispensing and record keeping of Controlled Substances.
· Knowledge of the Standards For Practice of Pharmacy in the Ambulatory setting preferred
· Experience in teaching clinical skills and other pharmacy practice standards
· Computer skills (word processing and spread sheet).
· Ability to articulate thee mission/vision of Unity Health care through the application of its policies and procedures.
The Director of Pharmacy reports directly to the Chief of Pharmacy Services.
The position abides by all rules and regulations set forth by applicable licensing and regulatory bodies; and the UHC policies and procedures.
The position requires contact with staff at all levels throughout the institution, there may be some contacts with the patients. There are also external organization relationships that may be a part of the work of this individual.
See ADA Checklist
See ADA Checklist
OTHER SIGNIFICANT FACTS
Although the position may be assigned a specific shift this position may be assigned alternate and rotating shifts and may be required to provide on-call coverage in order to the address the needs of Unity Health Care and the patients.
The position involves everyday risk and discomforts, which require normal safety precautions typical of such places as offices, meetings, training rooms, and other UHC health Care Sites. The work area is adequately lit, heated, and ventilated. The position requires contact with staff at all levels throughout the organization. There are also external organization relationships that may be a part of the work of this individual. All medical services shall be provided according to medically accepted community standards of care. The employee shall provide evidence of a recent (within the past twelve (12) months) health assessment that includes a PPD and/or chest x-ray results.
The statements contained herein describe the scope of the responsibility and essential functions of this position, but should not be considered to be an all-inclusive listing of work requirements. Individuals may perform other duties as assigned including work in other areas to cover absences or relief to equalize peak work periods or otherwise balance the workload.