Director, Clinical Systems Operations – Pharmacy

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🔥 0 minutes ago

🏈 Alabama, Arizona, +38 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote ⛰️ Colorado – Remote 🦌 Connecticut – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $134.6k - $249k / year

⏰ Full Time

🔴 Lead

🏥 Clinical Operations

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Oversee the development, implementation, and operation of medical management information systems and new technology solutions • Lead Clinical Systems for the Pharmacy team • Coordinate 50+ clinical program and initiative workflows across business rules • Oversee 10,000+ programmed communications and annual volume exceeding 8 million • Manage systems supporting direct clinical interactions and other clinical program activities • Provide business rules for clinical data informatics to identify populations and medication-related problems • Link 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, enhancements, business cases, requirements, regulatory programming and reporting, software defects, feature implementation, vendor activities, integrations, and UAT • Partner with IT to support system and program needs • Provide direction to business functions and ensure alignment with standard solutions and processes • Evaluate system and program performance and implement improvements • Oversee new clinical system implementations and upgrades • Oversee investigation and resolution of clinical system issues • Manage a team of 11, including 4 direct reports

🎯 Requirements

• 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 • Prior ownership of clinical applications and clinical systems operations leadership, pharmacy or managed care operations, regulatory compliance and reporting, vendor management, healthcare technology platform management, workflow and process optimization, and cross-functional leadership highly preferred • Able to travel up to 30% of the time • Support Eastern or Central business hours

🏖️ Benefits

• Competitive pay • Health insurance • 401K and stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Equal opportunity employer committed to diversity