VP PBM Operations - ClearScript

Provide overall leadership, management and direction to all ClearScript business operations.  Responsible for management and direction of ClearScript including cost-effective service delivery, consistently meeting customer expectations related to service, clinical effectiveness and patient safety; development and implementation of pharmacy network design and management, pharmacy and PBM vendor contracting and relations; pharmacy information systems, quality measurement and improvement programs, human resources management, regulatory compliance, program implementation, and effective financial management related to productivity and budgeting.  Will work cross-functionally with internal teams to coordinate processes that ensure team members to align and influence business strategy and drivers, with a focus on systematically improving operational execution to ensure the organization delivers on promises to key stakeholders.

• Develops and implements effective short-term and long-term strategies for ClearScript, and establish objectives and plans required for ClearScript’s ongoing growth and success. Provide leadership necessary to ensure the organization’s strategic plan is translated into clear, tactical goals and objectives that ensure consistent and timely progress toward achievement of performance objectives. Lead the ClearScript leadership and extended leadership team meetings, agenda and direction.
• Participate and lead, where appropriate with the President, key strategic discussions around collaboration and initiatives related to population pharmaceutical health with Fairview Health Services.
• Develop and foster strong working relationships and communication at all levels of the company to ensure succession and timely implementation of new strategies. Serve as ClearScript’s succession Executive for FPS Executive Leadership & Senior Leadership standing meetings, Lead Employee Engagement, including monthly All-Staff meetings, huddles and the creation of workplace standards. Coordinate implementation of corrective strategies to resolve problems or situations that arise. Problem-solve issues that are barriers to expected results.
• Recruit, select, and retain highly qualified professionals. Provide the leadership necessary to transform functional areas into motivated, productive and cohesive teams through open communication and delegation of responsibilities and authority. Guide and direct subordinates in their personal and professional development. Develop and implement a succession planning process to assure stability and continuity of key personnel.
• As part of the strategic planning process, assist in the development, implementation, and monitoring of strategic plans specific to changes in pharmaceutical care and trends in pharmacy contracting and pharmaceutical management. Ensure goals and objectives are developed, implemented, and executed to successfully manage pharmacy costs.
• Identify and assess emerging trends and conditions to educate the executive leadership team of potential scenarios that could impact the strategies, total cost of care objectives, and overall performance of the company.
• Lead cross-functionality across business units to develop and manage pharmacy and PBM vendor contracting and management efforts to achieve quality, positive value-based arrangements, and strategic business development objectives for the entire organization. Responsible for customer/member satisfaction with all services ClearScript performs or delegates to other vendors.
• Provide oversight of ongoing contract and relationship development with subcontractors, vendors, clients and brokers that improves both the clinical and quality performance of PBM services while supporting market expansion into new markets. ClearScript Executive for escalations/dispute resolution with subcontractors, vendors, clients and brokers.
• Establish quality control mechanisms to continuously drive operational efficiency through process redesign and data-driven analysis. Develops ClearScript budget with Finance and manages within budget parameters.
• Assist in strategic oversight of PBM information systems to support the clinical and business operations, to achieve more effective and cost beneficial PBM IT operations.
• Assigns appropriate resources as necessary and provides strategic direction to operational departments to support the goals of the organization in a streamlined and efficient manner and ensure that they work collaboratively to make performance improvements on functions that cross departments.
• Responsible for assessing all operational areas, focusing on identifying metrics and dashboards to drive the quality, accuracy, throughput, service levels, and efficiency of all operational processes to ensure scalability of growth including:
  • Account Services, to include client management, customer service, benefit plan design and implementation eligibility operations, and other operational units as developed or designated.
  • Clinical Services to include formulary operations, utilization management, clinical review processes, product pipeline assessments and product development, and other areas as developed or designated.
  • Account Projects operations to include client and member communications, internal and external communications, development and review of marketing materials related to operations, and primary liaison with FPS marketing and communications resources.
• Oversight and direction of project management resources and activities related to all operational areas of responsibility.
• Other duties as assigned by the President of ClearScript.

Required

Education

• Bachelor’s degree in pharmacy or other related field; or PharmD

Experience

• At least 8 years of increasingly responsible senior management experience in PBM operations, to include account services, clinical services, marketing/communications and project management.
• Knowledge of Medicare Part D and Health Exchange operations and requirements for PBM’s.
• Leadership experience in pharmacy network development/ PBM vendor contracting/services leadership role with a PBM company environment.
• Experience leading or collaborating with PBM support functions (i.e., call and claims centers, billing and enrollment, operations, etc). while supporting negotiations with strategic partners, both internal external, to ensure service commitments are set and met.
• Strong leadership skills as evidenced by the ability to effectively direct and lead various multi-functional teams on a variety of strategic initiatives, product offerings, operations, and reimbursement strategies to support execution of the organization’s annual and long-term strategic goals.
• Comprehensive knowledge of PBM operations with recent hands-on experience successfully leading two or more PBM functional areas at one time.
• Proven track record of creating accountability, driving strategic and organizational agility, engaging and developing people, and guiding transformational change.

Preferred

Education

• MBA

Experience

• PBM business development experience within an integrated healthcare system. Five years management experience with multi-disciplinary PBM operational teams

License/Certification/Registration

• MN Pharmacy License