Supervisor, Clinical Pharmacist Reviewer MediCal
Company: Magellan Health
Location: Rancho Cordova
Posted on: June 19, 2022
This position has managerial and clinical oversight of the
Clinical Pharmacist and Registered Nurse Review Team, playing a key
role in medical and pharmacy management. Leads and grows the
clinical performance of a team of Clinical Pharmacist and Nurse
Reviewers while supporting and enhancing provider experiences,
meeting service level agreements, exceeding client expectations,
and achieving revenue goals and operational objectives. Responsible
for day-to-day tactical activities, performance trending,
performance managing/coaching/developing clinical
pharmacists/nurses and time management. Responsible for the
delivery of superior customer service by maximizing employee
clinical performance and ensuring calls are answered effectively
and efficiently by supervising inbound and outbound calls,
resolving escalated calls, assisting pharmacists/nurses with
clinical and/or client related questions, auditing clinical
notations for accuracy, ensuring agents adherence to schedules and
ensuring compliance to policies, regulations, and procedures.
Motivates agents to peak performance through positive coaching,
constructive feedback and incentives, demonstrates a commitment to
the company s mission and vision, and supports activities that
strengthen the client relationship and grow the organization.
- Drives the daily performance of a team of Clinical Pharmacist
and Registered Nurse Reviewers ensuring clinical criteria is
accurately collected, notated, and recommendations appropriately
- Provides feedback and improvements in daily workflow with
- Collects and provides timely, productive and measurable
feedback to ensure recognition, process changes and development
opportunities are maximized.
- Oversees the team's annual goal setting process, performance
evaluations and performance improvement plans, and ensures other
business targets are met and exceeded.
- Reviews new and updated client accounts, medications and
policies with pharmacists.
- Ensures compliance with clinical policies and procedures.
- Provides direction on achieving departmental standards while
encouraging and motivating them in promoting customer loyalty,
employee recognition, and revenue generation.
- Monitors inbound and outbound call traffic and makes
adjustments based on call traffic patterns.
- Actively participates in process/project conversations, emails
and activities that will improve effectiveness/experience for
client, agents, leadership, brands or partner departments
- Displays ownership and accountability for the customer
experience, employee relations, core business metric
targets/contributing factors and understanding of the organizations
policies and procedures.
- Supports team members, business and brand initiatives,
especially as related to achieving outstanding client experiences,
including engaged daily support, escalated customer resolution and
engagement in training and support areas as needed.
- Maintains reliability and flexibility to ensure team and
business needs are appropriately supported.
- Proactively addresses call center concerns and identifies areas
- Monitors agents for quality and training purposes.
- Handles system emergencies with direction from IT department
and/or appropriate vendor.
- Daily authorization reviews, taking into account health plan
requirements, including, but not limited to turn around times, type
and number of outreaches made, review times, and regulations.
- Coordinates with Initial Review Pharmacy Technician team as
- Produces monthly team reports detailing team activity, trend
analysis, goals/objective status and special projects, as
- Other duties as assigned.Other Job
RequirementsResponsibilities5+ years of clinical pharmacy
Managed care pharmaceutical service experience plus experience with
coaching physicians and prescribers on medication issues,
especially on specialty medications.
Knowledge of current clinical research related to specialty
Strong clinical research and implementation skills in practical
Analytic skills which can translate into practical and pragmatic
Strong clinical expertise to aid in enhancing the team s clinical
skills and knowledge
Strong team orientation with respect for all members.
Strong verbal and written communications skills.
People skills are essential that allow for the successful
consultation with physicians, prescribers and pharmacists and for
successful collaboration with company employees and external
vendors who do not directly report to this job.
Must be comfortable with using computers and the internet
Basic skills with Microsoft office products and ability to quickly
learn proprietary systems.General Job InformationTitleSupervisor,
Clinical Pharmacist Reviewer MediCalGrade30Work Experience -
RequiredClinical, PharmacyWork Experience - PreferredSpeciality
PharmacyEducation - RequiredBachelors - PharmacyEducation -
PreferredPharmD - PharmacyLicense and Certifications - RequiredRPH
- Registered Pharmacist - PharmacyLicense and Certifications -
PreferredPharmD - Doctor Of Pharmacy, State Licensure -
PharmacyMagellan Health, Inc. is proud to be an Equal Opportunity
Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every
employee must understand, comply with and attest to the security
responsibilities and security controls unique to their position;
and comply with all applicable legal, regulatory, and contractual
requirements and internal policies and procedures. Associated
topics: dietary, dietician, health, industrial hygienist, medical,
medicine, metabolism, microbiology, nephrology, toxicologist
Keywords: Magellan Health, Rancho Cordova , Supervisor, Clinical Pharmacist Reviewer MediCal, Other , Rancho Cordova, California
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