Supervisor, Formulary Operations

Pharmacy Benefits Management Specialist

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Essential Duties and Responsibilities include the following. (Other duties may be assigned.)

• Manages, mentors, and provides supervisory guidance and oversight to formulary administration specialists;
• Oversees the staff that manages the operational formulary processes, configuration and implementation activities for all Commercial, Part D, Medicaid, and Marketplace lines of business and Enterprise Formulary System. This includes technical and workflow support, intake assessment and assignment, and quality review of formulary work product prior to implementation and client distribution.
• Coordinates inter and intra-departmental and external inquiries and requests surrounding the past plan year audits, the current plan year maintenance and the future plan year build concurrently;
• Provides formulary-specific documentation of maintenance activities to clients and regulatory bodies as appropriate. Ensures compliance with policies and procedures and how-to guides for Formulary Administration and Strategy;
• Maintain and update policies and procedures
• Maintain and update job aids for Formulary Administration Specialists
• Manages and contributes to current priority projects, programs, or initiatives as defined by leadership. Coordinates inter and intra-departmental project activities and groups as necessary to meet project goals and timeframes;
• Provides direct client consultation on designated Formulary Administration and Strategy formulary maintenance operations, programs, and software;
• Assists in the delivery of appropriate, accurate, and consistent client specific formulary claims adjudication, formulary flat files, Plan Finder file, and other related program materials.
• Responsible for accurate and timely task estimation and status reporting to Formulary Administration and Strategy management. Executes within the confines and timeframes provided by CMS which may include non-standard business hours.
• Other reasonable tasks related to this job or to tasks in other departments that may be within the individual's skill set, as needed by management.

Supervisory Responsibilities :

Manages assigned staff in the segment area. Responsible for the overall direction, coordination, and evaluation of the unit. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Supports and enforces all company policies and procedures in a fair and consistent manner, taking corrective action whenever necessary.

Qualifications :

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Client Responsibilities :

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills. One must be able to; respond promptly to client needs; solicits client feedback to improve service; respond to requests for service and assistance from clients; meet commitments to clients; manage difficult or emotional client situations.

Education and / or Experience :

BS / BA Degree or equivalent; plus 2+ years of experience (or equivalent combination of education and experience) and 1 year of supervisory experience. Supervisory experience may be substituted with two (2) years of MedImpact experience plus an appropriate external leadership training program and internal mentorship with a seasoned leader at the Director level or above that must be completed within 12 months in new position.

Computer Skills :

To perform this job successfully, an individual should have knowledge of the entire Microsoft Office Suite of software tools as well as knowledge or ability to learn to use MedAccess and claims adjudication logic.

Certifications, Licenses, Registrations :

Pharmacy Technician license or equivalent experience.

Other Skills and Abilities :

Reasoning Ability :

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Mathematical Skills :

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, ratios, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.

Language Skills :

Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or government regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and general public.

Competencies :

Physical Demands :

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit and talk or listen. The employee is occasionally required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and / or move up to 35 pounds.

Work Environment :

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Work Location :

This position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.

Travel :

This position may require approximately 10% domestic travel and may require international travel in which case a valid passport and ability to leave the United States will be required.

The Perks :

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume.