SummaryThe Cincinnati VA Medical Center is looking for a Program Manager who will manage the program to receive, review and adjudicate NF and
PA medication requests. The Non-Formulary Program Manager/Care in the Community Pharmacist holds a position of high visibility and is responsible for managing the Non-Formulary Pharmacy (NF), Prior Authorization (PA) and oversight of Care in the Community medication adjudication program.
DutiesHelp
The Cincinnati VA Medical Center (CVAMC) is a two-division campus located in Cincinnati, OH and Fort Thomas, KY serving 15 counties in Southwest OH, Northern Kentucky, and Southeast Indiana with 6 Community Based Outpatient Clinics located in Bellevue, KY; Florence, KY; Lawrenceburg, IN; Hamilton, OH; Clermont County, OH, and Georgetown, OH. The CVAMC also supports two off main campus locations in the Cincinnati area via an Eye Center and Mental Health Outreach Community Division.
Duties:a. Program Management:- Serves as the program manager of the Cincinnati VA NF and PA medication adjudication program as it relates to implementation, enhancement, and standardization when appropriate.
- Participates in Medical Center, VISN-level, and VHA Pharmacy Committees, and Workgroups when requested.
- Develops and implements long and short-term goals and plans, which includes managing risks, identifying needs and potential issues in NF and PA medication order adjudication through analyzing workload, expenditures, trends, and national VA policy implications.
- Works collaboratively with appropriate pharmacy leadership to ensure NF and PA medication adjudication program services are consistent with professional standards.
- Consults with providers, contracted care providers outside VA for contracted care, and community care providers to obtain information necessary to adjudicate NF and PA medication requests.
- Provides education to VA and Non-VA providers on VA formulary selection and informs supervisor of providers who are continually outlier prescribers. Assists in creating education for VA and non-VA providers on formulary management and local NF and PA process.
- Maintains awareness of and achieves VA performance metrics outlined for adjudication of national prior authorizations and monitoring parameters.
- Manages the Cincinnati VAMC NF and PA medication adjudication program and team ensuring that workload is completed in a timely manner.
- Delegates authority, when necessary, to other staff to meet the goals of the program.
- Works collaboratively with pharmacy leadership regarding the program budget, business
- planning, forecasting, staffing and space plans to meet program expectations.
- Ensures effective personnel utilization and consistently assesses the organizational structure for
maximum utilization and effectiveness. - Analyzes and resolves problems and/or deficiencies in the staffing and effectiveness of program activities and the delivery of care to Veterans.
- Plans and coordinates changes in workload to meet deadlines and maintain a smooth workflow; evaluates resource needs; assigns, directs and reviews work of assigned staff and assures work is complete and accurate.
b. Quality Assurance:- Assists pharmacy leadership in developing and tracking monitors for program areas.
- Identifies outcomes that can be improved and leads the performance improvement process.
- Assesses the productivity, effectiveness and efficiency of operations and acts when appropriate.
- Assures allergy assessments are completed prior to processing orders in regard to a NF or PA medication request.
- Completes and documents reviews in the Electronic Health Record (EHR) in a timely manner (every effort will be made to complete reviews no later than 96 hours of medication request) and includes allergy assessment, ADR information, drug-drug and drug-food interaction potential, lab value assessment, elimination of duplicate/obsolete orders, and appropriate drug conversions.
- Contributes to the quality improvement/performance improvement of the Pharmacy Service by documenting system errors and working toward resolution of identified problem(s).
c. Clinical- Promotes and advocates for compliance with the VA National Formulary (VANF), VA criteria-for-use documents, and established Cincinnati VAMC Pharmacy medication restrictions.
- Maintains a good working knowledge of information resources, both written and electronic, as well as therapeutics and disease management areas covered by clinical pharmacy services.
- Maintains awareness of changes in the Pharmacy Benefits Management (PBM) Formulary services (e.g., formulary additions and deletions, relevant memoranda, and policies and procedures).
- Reviews and completes NF and PA drug requests for appropriateness, utilizing clinical knowledge, national and VISN treatment guidelines, drug use criteria, and relevant literature and resources. Conducts one on one education during adjudication and prescribers are provided with preferred, cost-effective therapeutic alternatives to improve patient outcomes.
Work Schedule: Monday - Friday, 8:00 am - 4:30 pm
Telework: AD HOC at supervisors discretion.
Virtual: This is not a virtual position.
Functional Statement #: 92931-0
Relocation/Recruitment Incentives: Not Authorized.
Permanent Change of Station (PCS): Not Authorized.
RequirementsHelp
Conditions of employment- You must be a U.S. Citizen to apply for this job.
- All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
- Selective Service Registration is required for males born after 12/31/1959.
- Must be proficient in written and spoken English.
- Subject to background/security investigation.
- Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
- Must pass pre-employment physical examination.
- Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
- Complete all application requirements detailed in the "Required Documents" section of this announcement.
As a condition of employment for accepting this position, you will be required to serve a 1 or 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider:
- your performance and conduct;
- the needs and interests of the agency;
- whether your continued employment would advance organizational goals of the agency or the Government; and
- whether your continued employment would advance the efficiency of the Federal service.
Upon completion of your trial period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.
QualificationsApplicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.
Basic Requirements:
- United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
- English Language Proficiency. Pharmacists must be proficient in spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d).
- Education
(1) Graduate of an Accreditation Council for Pharmacy Education (ACPE) accredited College or School of Pharmacy with a baccalaureate degree in pharmacy (BS Pharmacy) and/or a Doctor of Pharmacy (Pharm.D.) degree. Verification of approved degree programs may be obtained from the Accreditation Council for Pharmacy Education, 20 North Clark Street, Suite 2500, Chicago, Illinois 60602-5109; phone: (312) 664-3575, or through their Web site at: http://www.acpe-accredit.org/.
(NOTE: Prior to 2005 ACPE accredited both baccalaureate and Doctor of Pharmacy terminal degree program. Today the sole degree is Doctor of Pharmacy.)
(2) Graduates of foreign pharmacy degree programs meet the educational requirement if the graduate is able to provide proof of achieving the Foreign Pharmacy Graduate Examination Commission (FPGEC) Certification, which includes passing the Foreign Pharmacy Graduate Equivalency Examination (FPGEE) and the Test of English as a Foreign Language Internet-Based Test (TOEFL iBT).
Licensure. Full, current and unrestricted license to practice pharmacy in a State, Territory, Commonwealth of the United States (i.e., Puerto Rico), or the District of Columbia. The pharmacist must maintain current registration if this is a requirement for maintaining full, current, and unrestricted licensure. A pharmacist who has, or has ever had, any license(s) revoked, suspended, denied, restricted, limited, or issued/placed in a probationary status may be appointed only in accordance with the provisions in VA Handbook 5005, Part II, Chapter 3, section B, paragraph 16. - May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria).
Grade Determinations:
GS-13
Experience. In addition to the GS-12 requirements, must have 1 year of experience equivalent to the next lower grade level, GS-12.
Facility Program Manager. Manages all aspects of a distinct program to include policy development, quality resources and specialty functions unique to the program to optimize cost effectiveness (budget) and patient outcomes. Coordinates a single program area of a complex pharmacy operation, or multiple program areas within a facility to develop, organize, manage, and control complex pharmacy programs. Develops, organizes, coordinates, and manages single or multiple program areas within the medical facility; this may include a single program area at multiple facilities. The Program Manager title is reserved for those individuals who have one or more of the following: supervisory responsibilities for various sections within Pharmacy Service; a complex program requiring coordination of multiple locations such as medical center care facilities, Community Based Outpatient Clinics (CBOCs), rural health, telemedicine, etc; specialized areas of a complex nature such as nuclear pharmacy, quality assurance, pharmacy informatics, clinical applications coordinator, Home Based Primary Care, pharmacoeconomist or liaison pharmacist duties requiring the coordination of processes with other medical facilities or VISNs.
Pharmacists assigned to this position must demonstrate the following KSAs:
a. Ability to communicate orally and in writing to persuade and influence clinical and management decisions.
b. Expert understanding of regulatory and quality standards for their program area.
c. Ability to solve problems, coordinate and organize responsibilities to maximize outcomes in their program area or area of clinical expertise.
d. Expert knowledge of a specialized area of clinical pharmacy practice or specialty area of pharmacy.
e. Advanced skill in monitoring and assessing the outcome of drug therapies, including physical assessment and interpretation of laboratory and other diagnostic parameters.
Preferred Experience: 1 year at the GS 12 grade level.
Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.
Physical Requirements: Work is mostly sedentary in nature. Work requires moderate lifting, walking, bending, stooping, standing, pushing, and pulling.
EducationNote: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.
Additional informationReceiving Service Credit for Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed.
During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions.
This job opportunity announcement may be used to fill additional vacancies.
This position is in the Excepted Service and does not confer competitive status.
VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority.
If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement.
Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.
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Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.
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