What are the responsibilities and job description for the Director Pharmacy Financial Strategy and Operations position at Highmark Health?
Highmark Health Director Pharmacy Financial Strategy and Operations Honolulu, Hawaii Apply Now
As part of the enterprise strategy to integrate and scale pharmacy solutions that disrupt the pharmacy supply chain, this new position will be responsible for the execution and value realization related to strategy development, operational excellence, pricing optimization, vendor coordination, and assisting in the actuarial, financial planning and forecasting process. This role will lead the implementation of the key initiatives that fall within this strategy, including retail and mail network optimization, rebate, formulary & UM financial optimization, and additional programs to meet segment growth and financial goals.
ESSENTIAL RESPONSIBILITIES
- Perform management responsibilities to include, but are not limited to : involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.
- Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
- Develop and implement a comprehensive pharmacy pricing strategy including pricing lever management, rebate contracting opportunities, and pharmacy programs (network, formulary, UM, buy-up's) to achieve segment specific pharmacy enrollment and financial goals. In doing so, the role is responsible for the financial strategy and assumption development to support segment pricing and pharmacy trend. Subject matter expertise to support inputs into financial plan, trends, forecast and accrual assumptions.
- Pharmacy Benefit Manager (PBM), pharmacy Group Purchasing Organization (GPO) and vendor partnership financial oversight. Including providing client pricing assumptions, client pricing and underwriting development for "new to Blue" (NTB), renewals and Requests for Proposal (RFPs).
- Oversees the pharmacy pricing internal operations including pricing vendor operations related to MAC management, pricing tier development and execution. Oversight and execution against pharmacy financial levers and the management of those levers.
- Leverage data, market insights, and competitive intelligence to identify trends, improve decision-making and optimize performance through the use of pharmacy data analytics. The result of this work will lead to market competitive strategies to be used across the segments (Commercial FI, Commercial ASO, ACA, and Medicare).
- Other duties as assigned or requested.
EXPERIENCE
Required
Preferred
SKILLS
EDUCATION
Required
Substitutions
Preferred
LICENSES or CERTIFICATIONS
Required
Preferred
Language (Other than English) :
None
Travel Requirement : 0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office- or Remote-based
Teaches / trains others
Occasionally
Travel from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products / services (sales employees)
Never
Physical work site required
Lifting : up to 10 pounds
Constantly
Lifting : 10 to 25 pounds
Occasionally
Lifting : 25 to 50 pounds
Rarely
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 : 126,400.00
Pay Range Maximum : 236,000.00
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.
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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
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Salary : $236,000
