Highmark Health Director, Government Pharmacy Services in Pittsburgh, Pennsylvania

Description

JOB SUMMARY

This job develops and implements pharmacy benefit strategies that align with and help achieve the overall goals of the MA and ACA markets with respect to the pharmacy benefit. This includes product and program strategies and provider and member outreach strategies. Manage and work collaboratively with other Organization business units to determine and assess product needs that align with the Organization's overall goals within each government market segment. Work closely with the government P&L SVP’s and the Government Executive Medical Director to track pharmacy and medical cost trends and contribute to the turnaround and success of those products by achieving cost savings and revenue enhancements. Build strategic relationships with Providers, Pharmacy Consultants and brokers to act as a resource for the Pharmacy aspect of the Organization's government programs.The incumbent will work closely with other Pharmacy teams including Clinical Pharmacy Strategies, Clinical Pharmacy operations and Pharmacy Benefit Operations to assess market impact and operational impact of product and provider strategies.

ESSENTIAL RESPONSIBILITIES

  • Direct and lead staff members in developing pharmacy product initiatives, in order to reduce care costs of the Government market segments.

  • Develop provider outreach strategies with the goal of changing and/or driving prescriber behavior to drive care cost savings in the government market.

  • As part of the Med Econ process within the Organization, analyze pharmacy and medical drug data trends in order to develop pharmacy strategies that can be put in place to lower pharmacy trend rates in the government market.

  • Interact with pharmacy consultants and brokers regarding the pharmacy benefit for the government markets.

  • Direct and provide oversight to staff with planning and assigning work, including: instruction and direction to staff regarding solutions to meet business issues; negotiate project deliverables; anticipate impact and propose solutions; research and analyze complex operational business processes or system applications; and adhere to standards/procedure.

  • Communicate effectively with all levels of the organization and direct staff members to perform in a similar fashion. This includes: identifying and articulating issues to senior management, steering committees and/or project sponsors; developing business solutions to satisfy complex project goals and objectives; conducting problem solving resolution and decision making sessions; and establishing and maintaining customer touch points.

  • Direct staff in overall duties, which include: delegation of assignments, providing guidance and professional development, coaching and mentoring support, development and monitoring of employee performance on a regular basis to facilitate the attainment of departmental goals. Promote a culture of performance excellence departmentally by: directing and implementing quality process improvement and tools training/certification; encouraging staff members to build and maintain effective relationships throughout organization to advance a culture of performance excellence.

  • Direct staff in assessment and implementation of projects and products. This includes oversite that projects are assessed and implemented in a timely fashion. This also includes direction assessing both Pharmacy and other departments needs related to pharmacy related products and projects.

  • Other duties as assigned or requested.

EDUCATION

Required

  • Bachelor's Degree in Business, Healthcare or other related field

Substitutions

  • None

Preferred

  • PharmD

EXPERIENCE

Required

  • 8 years of leadership experience in Managed Care, Prescription Drug Benefit or Pharmacy Manufacturing environment

  • Demonstrated success in reducing pharmacy/drug cost trends

Preferred

  • 8 years of work experience managing vendor relationships, including developing RFPs, evaluating proposals and transition activities

  • 8 years of work experience in negotiation and contracting

  • 8 years of experience in project management in a leadership role

  • P&L experience

Skills

  • Superior Leadership Skills

  • Superior verbal and written communication skills

  • Working knowledge of MS Office products

  • Strong critical and strategic thinking skills

REQNUMBER: J127268

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled