This position is located in the Boston Area. Looking for someone who is willing to commute or relocate to the Boston Area (relocation assistance is available).
Under the administrative oversight of the Director, Pharmacy Benefit Management Operations and Strategy, the Manager of Pharmacy Operations are responsible for the oversight, development, implementation, and maintenance of systems, as well as policies and procedures related to pharmacy operations. This individual serves as the primary liaison to operational counterparts at
the pharmacy benefit management (PBM) vendor to ensure accuracy and execution of pharmacy-related initiatives, programs, and benefit designs developed and implemented by the Pharmacy Department for Commercial, Qualified Health Plans (QHP) and Medicaid. This individual collaborates with key stakeholders to develop and support administrative and medical cost savings opportunities. This individual manages the work of the Pharmacy Operations Team (approx. 4 -8 team members) to ensure that business results are successfully achieved. This individual interprets and complies with regulatory, compliance, and accreditation requirements for pharmacy operations and programs. As a
Manager in the Pharmacy Department, this individual is a strong leader who engenders confidence among internal and external constituents.
Bachelor’s degree and managed care experience required.
Prior management and operations experience preferred.
7-10 years of progressive business experience in health care and/or managed care. Experience in health care service delivery, customer relations, and regulatory/compliance. Possess a fundamental knowledge of health care delivery systems, managed care, and provider reimbursement methodologies and health policy issues. Experienced with large-scale project implementation and project management is desired
7-10 years of management experience supervising high-level professionals required, with demonstrated success in program development and execution
Experience with healthcare operations, pharmacy benefits, formulary administration, and data analysis
Must possess exceptional critical thinking skills and strong leadership skills; must have proven the ability to be flexible and achieve goals and deliver bottom-line results in situations where business priorities and the business environment are changing
Experience with managing and influencing a diverse group of stakeholders
Experience driving process improvements with significant business results
Experience with taking calculated risks, exercising sound judgment and initiative