Molina Healthcare · 21 hours ago
Regional Account Manager, Pharmacy Services (Remote)
United States
Full-time
Remote
Senior Level
7+ years expMolina Healthcare is a company focused on providing healthcare services, and they are seeking a Regional Account Manager for Pharmacy Services. This role involves leading a team of pharmacy staff to ensure member access to necessary prescription drugs while contributing to the overall pharmacy strategy and managing various pharmacy-related projects and compliance initiatives.
Health CareHospitalMedical
Responsibilities
Provides oversight of the Pharmacy Benefit Manager (PBM) for designated health plan(s), including tracking of service warranties and performance guarantees
Provides assistance with pharmacy related health plan and corporate projects
Supports state health plan functions, goals, and initiatives
Represents as direct pharmacy contact for state agencies as needed
Identifies pharmacy related trends and implements process improvement related changes as needed
Liaises with member and provider service teams for both Molina and the PBM
Maintains the pharmacy SharePoint and provides feedback and support related to website updates
Develops both routine and ad hoc pharmacy member and provider communications
Supports pharmacy leadership in reviewing and updating state specific policies and procedures to ensure compliance with contractual and regulatory requirements
Provides ad hoc pharmacy related reporting
Provides subject matter expertise for pharmacy compliance and legislative regulations
Provides support for corporate pharmacy quality related initiatives
Provides support for state/Office of Inspector General (OIG) investigations
Provides support for the state member lock-in program
Provides support for state specific formulary management
Provides support for health plan pharmacy encounters
Manages and resolves urgent issues for health plan(s). e.g. state complaints related to pharmacy
Supports and completes all pharmacy audits as required (SOX, CMS, internal, network, etc.)
Acts as primary liaison to PBM for health plan(s)
Provides supervision to pharmacy staff, and demonstrates accountability for performance
Provides coaching for pharmacy staff and helps identify and provide training needs in collaboration with pharmacy leadership
Qualification
Required
At least 7 years of experience in pharmacy, pharmacy managed care or Pharmacy Benefit Manager(PBM), or equivalent combination of relevant education and experience or equivalent experience
At least 1 year management/leadership experience
Ability to present ideas and information concisely to varied audiences
Knowledge of processes and systems necessary to develop and deliver necessary training to departmental staff and internal customers
Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors
Proficiency in compiling data, creating reports and presenting information
Ability to meet established deadlines
Ability to function independently and manage multiple projects
Excellent verbal and written communication skills
Microsoft Office suite, and applicable software program(s) proficiency
Preferred
Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required), or Doctor of Pharmacy (PharmD) license. If licensed, license must be active and unrestricted in state of practice
Health plan pharmacy operations experience
Benefits
Competitive benefits and compensation package
Company
Molina Healthcare
Molina Healthcare is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$2.35B2025-11-17Post Ipo Debt· $850M
2024-11-13Post Ipo Debt· $750M
2021-11-16Post Ipo Debt· $750M
Leadership Team
Dave Reynolds
Executive Vice President, Health Plans & Medicaid Chief Operating Officer
Debbie Simkins
Vice President, Office of the CIO
Recent News
2026-01-17
Company data provided by crunchbase