Manager Medical Drug Strategy Operations

Highmark Health • Springfield, IL • 2h ago

Company :

Highmark Inc.

Job Description :

JOB SUMMARY

This job will provide direction and oversight to staff members for the end-to-end operations management of Highmark's traditional and innovative drug value strategy for all segments. The incumbent leads a team of non-clinical personnel, coordinating the execution of contracts, oversight of rebate invoicing activities, and ensuring accurate and timely allocation of rebate money to clients. This position will work with internal and external partners to ensure processes and systems are functional, accurate, and timely.

ESSENTIAL RESPONSIBILITIES

Perform management responsibilities to include, but not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, and manage the day-to-day operations of the team; develop and implement policies and programs as necessary; manage to assigned budgets.

Direct and lead staff members in operationalizing Highmark's drug value strategies. Maintain relationships with internal and external operational and technical support teams.

Manages end-to-end invoicing of traditional and value-based drug rebate agreements, including ensuring technical function, data accuracy, and process efficiency.

Oversees end-to-end technical aspects of traditional and value-based medical drug rebate agreements, including drafting, redlining, and final execution.

Communicate effectively with all levels of the organization. Direct and encourage staff members to communicate effectively with all levels of the organization. To include: Identifying and articulating problems 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 for complex issues and projects; Establishing and maintaining customer touch points.

Ensures timely and accurate receipt and allocation of rebate funds to Highmark and clients.

Other duties as assigned or requested.

EXPERIENCE

Required

7 years of experience of progressive experience in health plan strategy, health plan administration, program or product development within a health system, health plan, or pharmacy benefit manager setting OR completion of an accredited PGY-1 Managed Care Pharmacy Residency Program plus 4 additional years of related, progressive experience in health plan strategy, health plan administration, program or product development within a health system, health plan, or pharmacy benefit manager setting

5 years of experience in a leadership or management role

Preferred

1 year of experience in a health plan or pharmacy benefit manager pharmacy department supporting strategic care cost savings initiatives

Completion of an accredited PGY-1 Managed Care Pharmacy Residency Program

SKILLS

Analytical and logical reasoning/thinking

Problem solving and decision making

Oral and written communication skills

Management

Team building

EDUCATION

Required

Bachelor's degree in Business, Healthcare or related field or relevant experience and/or education as determined by the company in lieu of bachelor's degree.

Preferred

Master's degree in Business, Healthcare, or related field

Doctor of Pharmacy degree

LICENSES or CERTIFICATIONS

Required

None

Preferred

Registered Pharmacist (Non-State Specific)

Language

None

Travel Required:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-Based or Remote Position

Physical work site required

Frequently

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

$118,400.00

Pay Range Maximum:

$196,800.00

Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Req ID: J282692

Go to Apply

[Remote] Principal Software Developer- Agent Toolkits & Cloud Infrastructure, Healthcare AI

Oracle • Springfield, IL • 5d ago

Hospital & Medical

Job Description Building off our Cloud momentum, Oracle has formed a new organization - Oracle Health & AI. This team will focus on product development and product strategy for Oracle Health, while building out a com...

5d ago

Go to Apply

Medical Coding Auditor

Humana • Springfield, IL • 6d ago

Hospital & Medical

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical C...

6d ago

Go to Apply

Global Account Manager - Building Automation for Hospitality Vertical

Honeywell • Springfield, IL • 1w ago

Hospital & Medical

In this role, you will impact the company significantly. By effectively managing and growing key accounts, you will drive revenue growth and contribute to the company's overall financial success. Your ability to build st...

1w ago

Go to Apply

Pre-Authorization Nurse

Humana • Springfield, IL • 1w ago

Hospital & Medical

Become a part of our caring community As a remote Pre-Authorization Nurse, you will report to a Supervisor of Pre-Authorization Nursing. You will coordinate care for MHS beneficiaries receiving care outside the MTF. You...

1w ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)