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Director, Clinical Systems Operations (Pharmacy)
Contract type
Part-time
Work mode
Remote
Experience
Senior · 7+ years
Job description
Director, Clinical Systems Operations (Pharmacy) at Centene, overseeing the development, implementation, and operation of medical management information systems and technology solutions for pharmacy clinical programs. The role leads a team of 11 (including 4 direct reports) and coordinates clinical program workflows, communications, and system enhancements in partnership with IT.
At a glance
- Employment
- Full-time · Employee (employment agreement)
- Work mode
- Remote
- Pay
- USD 134,600 – 249,000 / year
What you'll do
- Oversee the development and functionality of clinical systems and programs to improve efficiency and effectiveness, including system design and requirements gathering
- Provide direction and guidance to various business functions to ensure systems meet business expectations and alignment with standard solutions and processes
- Evaluate systems and programs performance, recommend improvement opportunities and implement changes
- Oversee the implementations of new clinical systems and upgrades and modifications of existing clinical systems
- Oversee the investigation and resolutions of issues of all clinical systems
- Coordinate 50+ clinical program and initiative workflows across various business rules
- Oversee 10,000+ programmed communications to members, providers, and pharmacies, with an annual volume of more than 8 million
- Manage the systems that support direct clinical interactions with members and other clinical program activities
- Provide business rules for clinical data informatics to identify populations and medication-related problems by linking eligibility, medical, and pharmacy claims data across large data sets
- Manage program triage to pharmacists and technicians based on program type, language, and state board of pharmacy licensure rules
- Oversee system documentation and enhancements, business cases and business requirements, regulatory programming and reporting requirements, software defects, new feature implementation, vendor activities, system integrations, and User Acceptance Testing (UAT)
- Partner closely with IT to support system and program needs
- Able to travel up to 30% of the time
What we're looking for
- Bachelor's degree in Nursing, Computer Science, Business Administration, MIS or clinical related field or equivalent experience
- 7+ years of applications, project management, or implementation experience
- Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff
Nice to have
- Prior ownership of clinical applications and clinical systems operations leadership
- Clinical systems operations leadership
- Pharmacy or managed care operations
- Regulatory compliance and reporting
- Vendor management
- Healthcare technology platform management
- Workflow and process optimization
- Cross-functional leadership
Your team
Pharmacy team
Team of 11 individuals, including 4 direct reports; leads Clinical Systems for the Pharmacy team
Apply
About Centene Corporation
Connect people to the care they need to live healthier lives
Mission
Connect people to the care they need to live healthier lives and make healthcare more accessible and effective
What they value
- Diversity
- Committed to improving lives