Plan Pharmacy Director
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The Plan Pharmacy Director serves as the primary point of contact and is accountable to the Kansas Community Plan leadership and the state Medicaid agency related to execution of the pharmacy benefit program and strategy.
The Plan Pharmacy Director is a dedicated resource and key staff of the Kansas Health Plan, that is accountable for setting the strategic direction, operational execution, oversight and financial impact analysis of pharmacy program priorities for the health plan. The role includes preferred drug list (PDL) implementation and maintenance activities, pharmacy reporting, management of state pharmacy relationship, active engagement at pharmacy related meetings with internal and external stakeholders as the pharmacy subject matter expert, key contact for pharmacy to internal and external stakeholders, developing and executing pharmacy strategy, ensuring pharmacy benefit compliance, communicating pharmacy trends and value proposition, developing and executing on affordability initiatives, supporting clinical and quality initiatives. This position will be part of the UnitedHealthcare Community and State Pharmacy team, reporting directly into the Regional Director Pharmacy Services.
If you reside in the state of Kansas, you will have the flexibility to work remotely
- as you take on some tough challenges.
Primary Responsibilities :
Executes the pharmacy benefit and compliance with the state contract, state policies, and state / federal statutes and regulations governing pharmacyRepresents plan at Kansas Medicaid Drug Utilization Board meetingsOversees preferred drug list (PDL) implementation and maintenance activitiesUtilizes broad understanding of managed care and PBM knowledge to develop, execute, and drive strategic plans and goalsEnsures timely submission of accurate pharmacy reports and deliverables as required by the state Medicaid agency and the health planAnalyzes forecasting and trend information for operational and business planningBuilds and maintain strong relationships with internal and external partners and serve as the primary point of contact for Pharmacy and Pharmacy ServicesAssists plan on all pharmacy related activities including clinical program development and improving member satisfactionAccountable for creation and maintenance of state specific policiesServes as the SME SPOC for formulary, prior authorization and benefit coding requirements and execution and responsible for communication with stakeholders for implementationDemonstrates a strong working knowledge of health plan operations (compliance, finance, encounters, claims adjudications, networks, clinical, case management, HEDIS measures, etc.)Collaborates with internal partners to complete projects and to address on-going pharmacy service needs of the planCommunicates pharmacy program changesEngages state Medicaid, pharmacy and health plan association meetings and build relationships as the health plan pharmacy subject matter expertSupports the health plan departments to ensure resolution of pharmacy related issuesProvides strategic direction, operational oversight, and financial impact analysis as it pertains to pharmacy program priorities for the health plan.Trains and educates on relevant policies and procedures related to the pharmacy benefitOther duties as assignedYou'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications :
B.S.Pharm or Pharm.D.Current, unrestricted Kansas Pharmacist license3+ years of Clinical Pharmacy, Sales, or Account Management experience or combination thereof3+ years of experience in Managed Care Pharmacy either in a Health Plan or PBM1+ year of direct experience with Medicaid / Medicare plansExperience in engaging, and presenting, to groups including senior level managementIntermediate to advance proficiency in Microsoft Office Suite, including Word, Excel and PowerPointResides in KansasPreferred Qualifications :
Excellent verbal and written communication skillsProven ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from othersHighly motivated and self-directedProven excellent time management, organizational, and prioritization skills and ability to balance multiple prioritiesProven prior experience working with pharmacy data and experience with Pharmacy Utilization Review and understanding pharmacy trendAll employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyPay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline : This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.