1+ months

Clinical Quality Manager of Pharmacy - San Antonio, TX

San Antonio, TX 78205
  • Job Code

As one of the largest pharmacy benefits managers in the United States, UnitedHealth Group provides a professional culture where you're empowered and encouraged to exceed the expectations of our members, with better schedules than retail and more reach than any hospital. Join us and start doing your life's best work.(sm)


Under the direction of the Director of Pharmacy Operations, the Clinical Quality Manager of Pharmacy will be responsible for the overall Star performance of Part D measures and end to end pharmacy operation activities-creating, controlling, and improving pharmacy care processes. The position will provide data expertise and recommendations related to staffing; resource planning and scheduling to ensure optimal call center performance and efficiency are achieved. The position will also be responsible for metric monitoring / oversight, quality reporting, analysis and audits, and updating and maintaining the department SOPs and P&Ps. This position is also responsible for developing plans and programs to support continuous quality improvement using applicable tools.


Primary Responsibilities: 

  • Pharmacy Operations Management:
    • Develop and implement pharmacy quality programs / initiatives to ensure quality initiatives are implemented across the department
    • Collaborate with pharmacy leaderships to plan and monitor the day-to-day pharmacy operations to ensure smooth progress on planned initiatives
    • Evaluate regularly the efficiency of business processes according to organizational objectives and ensure there's good processes for improvements when necessary
    • Diagnoses process improvement opportunities and develops solutions using principles of process excellence and related tools
    • Facilitates a Business Process Review workshop on a regular basis with all SMEs present to discuss opportunities, issues, and action plans
    • Continuously monitors and analyzes call center data to identify trends and recommend / develop realistic and effective strategies and solutions
    • Liaise with pharmacy leadership to make decisions for operational activities and set strategic goals
    • Manage and coach the direct reporting individuals
    • Evaluate overall performance by gathering, analyzing and interpreting data and metrics
    • Participates in designing, implementing  and evaluating systems, processes and methods designed to enhance quality, improve customer service and  reduce pharmacy related costs
  • Training and Development:
    • Oversee the development of effective training materials utilizing a variety of media appropriate for each phase of training
    • Updates and maintains the department SOPs, job aids, workflow processes etc. in SharePoint
  • Quality Assurance:
    • Oversee the daily functions of the quality assurance team to ensure all pharmacy initiatives are audited timely and accurately
    • Establish quality and reliability standards
    • Works with pharmacy leadership to establish root of identified staff performance problem
    • Ensures training materials are consistent with the department and corporate policies and procedures
  • Compliance:
    • Evaluates new hires during first 90 days against established standards of compliance
    • Notifies supervisors and managers of employees who have not met established standards of performance / compliance
    • Evaluates performance of staff against established goals and objectives in training and orientation
    • Updates and maintains pharmacy program policies and procedures to ensure compliance

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.



Posted: 2019-11-01 Expires: 2019-12-29

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Clinical Quality Manager of Pharmacy - San Antonio, TX

UnitedHealth Group
San Antonio, TX 78205

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