Managed Care Marketing Manager jobs in Austin, TX

Managed Care Marketing Manager develops and implements marketing plans for a managed care organization. Promotes the organization's services to potential members and business partners. Being a Managed Care Marketing Manager identifies and targets new opportunities and sources of additional business and revenue. Requires a bachelor's degree. Additionally, Managed Care Marketing Manager typically reports to a head of a unit/department. The Managed Care Marketing Manager typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Managed Care Marketing Manager typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Managed Care Pharmacist
  • Central Health
  • Austin, TX FULL_TIME
  • Overview

    Central Health is Travis County's hospital district. We provide access to quality healthcare for under-resourced individuals within the county. Sendero Health Plans is the non-profit, community-based insurance plan of Central Health, Travis County's hospital district. Sendero offers On-Exchange individual coverage through the Marketplace, and partners with Central Health to operate special enrollment windows to bolster the coverage of the local safety net. Central Health governs and oversees the Medical Access Program for low-income Travis County residents, including formulary and Pharmacy Benefits Management (PBM) functions. Core to its mission to provide access to comprehensive, high-quality care for low-income residents of our community, Central Health also employs direct practice specialty providers.

    The Managed Care Clinical Pharmacist will support managed care clinical pharmacy functions for both Sendero and Central Health programs and initiatives. The position provides highly specialized, integrated pharmacy services. The Pharmacist will provide drug utilization reviews based on established protocols for prior authorization and appeal requests, including provider outreach and engagement for educational purposes, as relevant. Forty percent of this providers time will be devoted to Sendero with the remaining sixty percent allocated to Central Health.

    The Managed Care Clinical Pharmacist will assist with:Developing prior authorization review criteria for medications covered on pharmacy and medical benefits. Conducting oversight over prior authorization criteria and delegated utilization management functions performed by PBM and other vendors in the pharmacy and drug space (e.g. rebate aggregator, e.g. specialty drug utilization review vendor). Reviewing PBM formularies to identify opportunities for improvement and optimization. Creating, refining and maintaining policies and standard operating procedures for pharmacy operational processes. Coordinating with vendors and internal data analytics teams to create appropriate, clinically informed datasets, and to conduct analyses that identify new issues and opportunities for better clinical pharmacy management practices. Developing evidence-informed and data-based clinical initiatives that support the processes of formulary management, plan design, prior authorization, retrospective drug utilization review, and coordination between PBM and medical drug benefit functions. Providing educational communication and clinical consultation, with Enterprise colleagues, providers and members. Overseeing patient assistance programs and similar initiatives to ensure medication access among our community. Providing leadership and guidance across the Enterprise to ensure proactive responses to shifts in the regulatory and statutory environment. Other duties as assigned, to ensure quality of care for members while meeting expectations for prescription drug cost containment.

    Responsibilities

    Essential FunctionsServe as a drug information resource for healthcare teams and act as a subject matter expert in the development of pharmacy programs and initiatives.Participate in EMR improvement efforts.Analyze drug utilization data to inform the development of departmental strategic plans and initiatives aimed at improving quality while meeting prescription drug cost containment goals.Oversee the Pharmacy Patient Assistance Program (PAP).Deliver education to students, residents, and other healthcare professionals.Assist delegated Pharmacy Benefit Manager (PBM) utilization management functions, including analyzing PBM claims data to identify drug utilization trends and cost-saving opportunities, such as prior authorization criteria and formulary management.Assist in PBM oversight, including participation in operational oversight meetings, Pharmacy and Therapeutics Committee meetings, periodic review of PBM activities, criteria, and issue resolution tracking.Contribute to the development of clinical initiatives supporting prior authorization processes, plan designs, formulary management, specialty pharmacy, provider/member communication, retrospective drug utilization review, and clinical consultation with members and providers.Ensure PBM vendor compliance with relevant performance standards, including contractual performance guarantees, cost monitoring, and utilization trend analysis.Participate in external and internal audits, regulatory inquiries, and external accreditation initiatives.Offer subject matter expertise in managed care pharmacy and participate in relevant work groups, committees, meetings, and activities.Monitor emerging trends and regulatory changes in the pharmacy industry and provide strategic guidance to align with departmental and enterprise objectives, aiming to improve quality while achieving medical expense goals.Develop and refine policies and standard operating procedures for pharmacy benefit operations.Ensure program compliance with State, Federal, and accrediting body regulations, implementing corrective action plans as necessary.Coordinate preauthorization requirements with the PBM and the medical preauthorization work groups.Perform administrative and other assigned duties.

    Qualifications

    Doctor of Pharmacy Required

    Minimum of 2 years of clinical pharmacy practice experience under a collaborative practice agreement, including providing drug therapy management in an ambulatory care clinical setting Required and2 years of applicable experience as a registered pharmacist with managed care job functions, such as for a health plan or Pharmacy Benefits Manager (PBM) Required and1 year of experience in PGY1 Managed Care Pharmacy residency Preferred or Experience with Medicare, Medicaid, Marketplace with a health plan or PBM Preferred and3 years’ experience as a registered pharmacist with managed care job functions, at a health plan or PBM working in utilization management, analytics, formulary management, and/or synthesis of clinical literature. Preferred and1 year of using EPIC Electronic Medical Record (EMR) experience Preferred

  • 22 Days Ago

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Sales Manager/Marketing
  • Rep Lock Marketing
  • Austin, TX FULL_TIME
  • About us Rep Lock Marketing is a small startup business in Austin, TX. We are professional, agile, and creative. Our work environment includes: Fun and Creative Supportive and Growth Minded Fast Past ...
  • 3 Days Ago

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Associate Manager, Influencer Marketing
  • Brilliant PR & Marketing
  • Austin, TX FULL_TIME
  • Brilliant PR & Marketing, one of the most respected and rapidly growing agencies focused on consumer brands, seeks a Full-time Coordinator, Influencer Marketing to help support the agency’s growing, a...
  • 3 Days Ago

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Program Manager, Managed Services
  • Insight
  • Austin, TX FULL_TIME
  • Requisition Number: 96129Program ManagerInsight Enterprises is a Fortune 500 Solutions Integrator helping organizations accelerate transformation by unlocking the power of people and technology. With ...
  • 23 Days Ago

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Marketing Business Planning Program Manager
  • Liaison Creative + Marketing
  • Austin, TX FULL_TIME
  • Overview: Bring your organizational and communication skills for high-profile projects with a global tech leader Location: Austin, Texas Compensation: Based on 2-4 years of experience. Hours/Duration:...
  • 28 Days Ago

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Account Manager
  • Fahrenheit Marketing
  • Austin, TX FULL_TIME
  • We are looking for a full-time Account Manager to join our team. We need a team player who can get things done, wants to learn and grow as an account manager and is driven by achieving excellent resul...
  • 1 Day Ago

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0 Managed Care Marketing Manager jobs found in Austin, TX area

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Shopper Marketing Manager
  • AF Ventures
  • Austin, TX
  • Location **Shopper Marketing Manager** Company Location Austin, Texas Other Sales + Help Siete reach shoppers in stores....
  • 3/28/2024 12:00:00 AM

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Digital Marketing Manager
  • Burnett Specialists
  • Austin, TX
  • Digital Marketing Manager Fortune 500 healthcare corporation is seeking a Digital Marketing Manager. Responsibilities fo...
  • 3/28/2024 12:00:00 AM

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Product Marketing Manager
  • Thales
  • Austin, TX
  • Location: Austin, United States of America Thales people architect identity management and data protection solutions at ...
  • 3/27/2024 12:00:00 AM

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Product Marketing Manager
  • Kibo Commerce
  • Austin, TX
  • ABOUT THIS ROLE As a Product Marketing Manager at Kibo, your role will be crucial to shaping the success of our company....
  • 3/27/2024 12:00:00 AM

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Content Marketing Manager
  • Travelstride
  • Austin, TX
  • Company Description Travelstride is an investor-backed startup, changing the way travelers find and book their perfect t...
  • 3/27/2024 12:00:00 AM

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Marketing Manager-Remote
  • Optima Global Solutions Inc.
  • Austin, TX
  • Marketing Manager-Remote Job Description: TranscendAP is(a subsidiary of Optima Global Solutions) a software company whi...
  • 3/27/2024 12:00:00 AM

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Market Manager
  • THE HEMP COLLECT
  • Austin, TX
  • *CANNABIS, HEMP INDUSTRY EXPERIENCE REQUIRED* WHO WE ARE: We make incredible cannabis products for the open market that ...
  • 3/25/2024 12:00:00 AM

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Creative Director | Marketing Lead • Blockchain • Equity
  • Blockchain 121
  • Austin, TX
  • Creative Director | Marketing Lead • Blockchain • Equity Hybrid | Austin Join a groundbreaking team revolutionizing the ...
  • 3/24/2024 12:00:00 AM

Austin is the capital of the U.S. state of Texas and the seat of Travis County, with portions extending into Hays and Williamson counties. It is the 11th-most populous city in the United States and the 4th-most populous city in Texas. It is also the fastest growing large city in the United States, the second most populous state capital after Phoenix, Arizona, and the southernmost state capital in the contiguous United States. As of the U.S. Census Bureau's July 1, 2017 estimate, Austin had a population of 950,715 up from 790,491 at the 2010 census. The city is the cultural and economic center ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Marketing Manager jobs
$85,538 to $118,501
Austin, Texas area prices
were up 1.2% from a year ago

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