This role encompasses the management and oversight of drug utilization and expenditure within the Pharmacy and Medical benefits. It involves the operational management of the Federal Employee Program's Employer Group Waiver Plan and Medicare Part D, collaborating with key stakeholders including pharmacy benefit managers, executives, and staff for contract administration. The position leads the FEP Pharmacy and Medical Policy Committee, supports the National Pharmacy & Therapeutic Committee, and maintains relationships with key Federal government agencies. It also involves directing medical drug policy development, managing pharmaceutical manufacturer engagement, and acting as a clinical expert for the pharmacy team. Additionally, it includes working on medical benefit drug implementations and pilot projects.
- Leads the overall management and strategic direction for the pharmacy program including Medicare Part D/EGWP program.
- Identifying new opportunities for optimal drug benefit control, analyzing utilization and pricing across medical and pharmacy benefits, developing tools to manage drug expenditure while maintaining clinical excellence, and presenting recommendations to senior leadership.
- Manages the pipeline, assessing the potential impact on the formulary and medical drug benefit, strategizing manufacturer engagement before and after product launch, and overseeing internal processes for Pharmacy and Therapeutics Committee and the National Pharmacy & Therapeutics meeting preparations, execution, and formulary status decisions.
- Lead internal & external presentations for national forums, Operations Conferences and Plan level presentations.
- Work collaboratively with key stakeholders to identify best practices for management of the drugs under the Medical Benefit. Work cross-functionally to determine process implications of suggested new programs and the operational implementation of initiatives under the medical benefit.
- Lead and manage a team with the aim of driving effective performance management, fostering professional growth, and creating a positive and inclusive work environment. This role is dedicated to utilizing strong leadership and communication skills to motivate and inspire team members, ensuring they are aligned with and committed to achieving the organization’s goals.
The posting range for this position is:
$172,326.00-$263,764.92
Qualifications:
Education
- Required Bachelor's Degree in pharmacy
- Required Doctor of Pharmacy
- Preferred Master's Degree Clinical advanced degree (various fields)Advanced degree in Business (MBA)
Experience
- Required 12+ Years experience in Managed Care Pharmacy or Pharmacy Benefit Management (PBM) experience with an emphasis on Specialty drug management
Knowledge Skills and Abilities
- Solid communication skills
- Strong Interpersonal skills
- Proven proficiency with applicable information technologies
- Analytical skills: ability to perform financial analysis on new products and services as well as basic SWOT analysis
Certifications & Licenses
#LI-Hybrid
The posted salary range is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs. This job is also eligible for annual bonusincentivepay.
We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.
Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.