Manager Pharmacy Contracting
Company: Highmark Health
Location: Indianapolis
Posted on: January 27, 2023
Job Description:
Company :Highmark Inc.Job Description :JOB SUMMARYThis job will
provide direction and oversight to staff members for the end-to-end
management of Highmarks traditional and innovative drug rebate
contracts for activities including contract negotiation, financial
modeling, contract execution, rebate invoicing and vendor oversight
(as applicable). Serves as primary contact with pharmaceutical
manufacturers and key vendors, including Pharmacy Benefit Manager.
Engages with internal and external stakeholders to execute
Highmarks drug contracting strategies and drive to low-net cost
medication benefit offerings for customers. Oversees relationships
with external client plans as part of Highmarks medical drug rebate
administration program. Responsible for departmental compliance
with contractual obligations and rebate administration for both
Highmark and external client plans.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.
- Direct and lead staff members in negotiating and executing drug
rebate contracting strategies, which reduce spend and
administrative costs and maintain a competitive position for
Highmarks benefit products. Manages relationships with key internal
and external stakeholders to develop and execute Highmarks
strategic drug rebate portfolio across pharmacy and medical
benefits. Directs end-to-end strategic and operational process for
managing traditional and innovative drug rebate contracts including
contract negotiations, execution, invoicing and vendor oversight
(as applicable).
- Oversees relationships with external client plans as part of
Highmarks medical drug rebate administration program. Support
external client plans in obtaining medical drug rebate
opportunities aligned with their plans drug management strategies
and philosophiesDirect staff members responsible for executing
strategic and operational components of medical and innovative drug
rebate contracts for external client plans.
- Oversee relationship with Highmarks Pharmacy Benefit Manager
engaged to provide pharmacy benefit drug rebate administration
services. Collaborate with Clinical Pharmacy team during formulary
management discussions to highlight the net financial impact of
proposed formulary changes while supporting Highmarks
clinical-first drug management philosophy.
- Ensure compliance with government drug rebate reporting
obligations of Highmark and any vendors (as applicable).
Responsible for oversight of audit response from internal and
external entities as related to drug rebate contracts.
- Direct and provide oversight to staff and assist with planning
and assigning projects to other staff members. Including but not
limited to: Provide project lead instruction and direction to other
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; Adherence to standards/procedures to include
obtaining pre- and post-implementation sign-offs.
- Promote a culture of performance excellence departmentally by:
Directing and encouraging quality process improvement and tools
training/certification; Encouraging staff members to build and
maintain effective relationships throughout organization to advance
performance excellence.
- 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.
- Other duties as assigned or requested.EDUCATIONRequired
- Bachelor's degree in Business, Healthcare or related
fieldSubstitutions
- NonePreferred
- Master's degree in Business, Healthcare (i.e., PharmD) or
related fieldEXPERIENCERequired
- 5 years in a drug rebate contracting process
- 5 years in a Health Plan, Pharmacy Benefit Manager (PBM) or
Pharmaceutical Manufacturer environment
- 3 years in leading a strategic function within a managed
healthcare environment (e.g., health plan, PBM)
- 1 year in an external customer-facing rolePreferred
- Experience leading pharmaceutical manufacturer rebate
negotiations and contracting strategy
- Experience in a Health Plan or PBM pharmacy department
supporting strategic care cost savings initiatives
- Registered pharmacist or Pharm DLICENSES or
CERTIFICATIONSRequired
- NonePreferred
- NoneSKILLS
- MS Office proficiency
- Excellent verbal and written communication skills
- Strategic thinking skills
- Relationship- building skills
- Analytic and business solutioning skillsLanguage (Other than
English):NoneTravel Requirement:0% - 25%PHYSICAL, MENTAL DEMANDS
and WORKING CONDITIONSPosition TypeOffice-basedTeaches / trains
others regularlyOccasionallyTravel regularly from the office to
various work sites or from site-to-siteRarelyWorks primarily
out-of-the office selling products/services (sales
employees)NeverPhysical work site requiredYesLifting: up to 10
poundsConstantlyLifting: 10 to 25 poundsOccasionallyLifting: 25 to
50 poundsRarelyDisclaimer: 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 Companys
Handbook of Privacy Policies and Practices and Information Security
Policy.Furthermore, it is every employees responsibility to comply
with the companys 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:$92,300.00Pay Range
Maximum:$170,800.00Base pay is determined by a variety of factors
including a candidates 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 their race, color, age, religion, sex, national origin,
sexual orientation/gender identity or any other category protected
by applicable federal, state or local law. Highmark Health and its
affiliates take affirmative action to employ and advance in
employment individuals without regard to race, color, age,
religion, sex, national origin, sexual orientation/gender identity,
protected veteran status or disability.EEO is The LawEqual
Opportunity Employer Minorities/Women/Protected
Veterans/Disabled/Sexual Orientation/Gender Identity (
https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf
)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 number below.For accommodation requests, please
contact HR Services Online at
HRServices@highmarkhealth.orgCalifornia Consumer Privacy Act
Employees, Contractors, and Applicants NoticeReq ID: J220710
Keywords: Highmark Health, Indianapolis , Manager Pharmacy Contracting, Executive , Indianapolis, Indiana
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