Director, Pharmacy Analytics
Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:
• Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
• Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
• Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.
Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.
JOB SUMMARY: The Director of Pharmacy Analytics provides highly specialized integrated clinical pharmacy services to the health plan. The Pharmacist will work with Community¿s Pharmacy Benefit Manager (PBM) to provide drug utilization reviews to identify outlier providers and also areas of member need. Working with Community¿s Medical Directors s/he will provide educational outreach to outlier providers. The Director of Pharmacy Analytics will provide delegation oversight of Community¿s PBM to ensure that regulatory requirements are being met. Oversight includes all lines of business (STAR, CHIP, D-SNP) and associated services. The Pharmacist acts as the educator for pharmacy and complex drug issues to Community employees and acts as a resource to providers and other external customers. In addition, s/he will assist in representing Community to the Texas Association of Community Health Plans (TACHP) Pharmacy and Therapeutics committee and to any other external organizations involving Community that requires pharmacist representation.
Benefits and EEOC
Community employees’ benefits are provided by Harris Health. These benefits are designed to provide you with flexibility and choices in meeting your specific needs.
Community is an Equal Opportunity Employer.