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Pharmacist - Clinical Programs Manager - Health Plan (8a - 8p) Variable 8 Hr. Shift

Houston, TX, US
    Position: Pharmacist - Clinical Programs Manager - Health Plan (8a - 8p) Variable 8 Hr. Shift
    Talent Area: Pharmacy
    Full/Part Time: Full time
    Location: Houston, TX, US
    Regular/Temporary: Regular
    Shift: 8a -8p / Full Time / Variable 8 Hr. Shift / Monday – Friday
    Job ID: 407001

We’re hunting for a Clinical Programs Manager - Pharmacist, someone who’s ready to be part of the best ranked children’s hospital in Texas, and among the best in the nation. In this position, you will be a key driver of the pharmacy based clinical programs, disease management initiatives, provider education, and utilization management review. This is an individual contributor role without direct reports but requires indirectly leading initiatives and other staff. This position works closely with leadership and other key personnel to execute operational goals, ensure quality control, and identify process improvement opportunities. The role serves as a resource and mentor to members, network providers, employees, and external collaborators.

Think you’ve got what it takes?

Job Duties & Responsibilities
•   Manage and enhance pharmacy based clinical initiatives for the health plan.
•   Ensure clinical projects and tasks are completed in a timely manner, and operational goals are met. Uses data to measure quantifiable outcomes and interventions, presents progress to leadership team. Provides support staff with guidance to ensure achievement of goals.
•   Manages and leads various clinical programs. Examples include: The Office of Inspector General (OIG) lock-in program, psychotropic medication utilization review (PMUR), retrospective drug utilization review (RDUR), prospective drug utilization review (PDUR), and others.
•   Coordinates and participates in performance and/or quality improvement activities. Identify process improvement opportunities. With support from leadership team, present and execute improvement plans.
•   Participates in and leads multi-disciplinary work groups involving clinical operations, accreditation compliance, and pharmacy benefit manager (PBM) oversight. This includes internal and external stakeholders.
•   Creates pharmacy guides and training content for internal and external stakeholders.
•   Completes clinical and compliance tasks.
•   Participates in the education of parents/members, providers, employees, and pharmacy students.
•   Performs other essential functions.

Skills & Requirements
•   Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees unless approved for a medical or religious exemption.
•   Required bachelor's degree Science in Pharmacy or Pharm. D. Doctor of Pharmacy
•   Preferred 1-year of Managed Care Pharmacy residency, 3 years managed care experience at a health plan or PBM working in utilization management, analytics, formulary management, and/or clinical literature. 1 year Residency experience in retail for this position or retail with hospital experience.

About Texas Children’s

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.

To join our community of 14,000+ dedicated team members, visit for career opportunities. You can also learn more about our amazing culture at

Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

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