Principal, Fee-For-Service Pharmacy Operations

MedImpact Healthcare Systems, Inc.; San Diego (CA); On-site; USD 180,000 - 337,000; Full time

Benefits offered by this job

Medical / Dental / Vision / Wellness

Paid Time Off / Holidays

Incentive Compensation

401K with Company match

Life and Disability Insurance

Tuition Reimbursement

Employee Referral Bonus

Job summary

MedImpact Healthcare Systems, Inc. in San Diego seeks a Principal, Fee-For-Service Pharmacy Operations to strengthen executive relationships and drive improvements across state Medicaid programs.

The role focuses on identifying operational enhancements and optimizing service offerings for Medicaid FFS clients. You will lead multi-disciplinary teams, coordinate with government and internal stakeholders, and ensure strategic alignment with regulatory requirements.

Qualifications

• BA/BS Degree required; 10+ years related experience with 8+ years SME in relevant area.
• Minimum 4+ years leading individual contributors and leaders of leaders.
• Experience with State Medicaid FFS programs and regulatory environments preferred.

Responsibilities

• Lead key project teams to exceed State Medicaid FFS requirements and oversee clinical oversight.
• Manage client implementations and FFS rebate operations and project teams.
• Maintain executive relationships with State FFS leaders and contractor clients.
• Identify opportunities to improve operations and overall product delivery for clients.

Skills

Executive relationships

Leadership

Regulatory knowledge

Communication skills

Public speaking

Strategic agility

Analytical thinking

Education

BA/BS Degree

Tools

MS Office

Industry databases

Internet research

Job description

Exemption Status

United States of America (Exempt)

$180,242 - $258,648 - $337,053

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

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!

Summary

Job Description

The role of the Principal, Fee-For-Service Pharmacy Operations focuses on forging strong executive relationships with both internally and externally. Additionally, this position identifies areas within the business that can be optimized, streamlined, and improved in order to improve product offerings of the Company.

Essential Duties and Responsibilities

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

• Leads key project teams to exceed current State Medicaid Fee-For-Service program requirements and expectations while coordinating with clinical program oversight
• Leads client implementations, FFS Medicaid rebate operations/teams as well as FFS Medicaid account and project management teams and other teams as assigned.
• Supports business relationship activities to enable the company to retain its State Medicaid FFS business customers. Serves as a company representative to key government customers and prospects
• Ongoing relationship management primarily focused on developing strong executive (C-suite) level relationships with State fee-for-service (FFS) executive leaders that are current MedImpact direct state contracting clients.
• Develops relationships by building trust and gaining knowledge of the business requirements of the organization.
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• Interacts with applicable internal staff to develop solicitation strategies, identify business requirements, and lends support to the sales cycle when applicable.
• Identifies areas (operational, administrative, process, reporting etc.) enterprise-wide where improvements would enable the enterprise to improve delivery of a differentiated business proposition to current clients. These areas would drive increasing revenues or improved enterprise efficiencies (less error, less liability, improved operational process flows, enhanced data capture and interpretation, improved management oversight, etc.). Efficiencies will increase the potential for new FFS, or other Regulated Programs to select MedImpact as its PBM.
• Develops relationships with potential non-MedImpact client leadership to further understand their businesses and business requirements while also imparting an agreed upon MedImpact message or messages. Builds trust to the point that these leaders or their designated staff would attend MedImpact sponsored activities (program WebEx’s, client conference, receipt of marketing materials etc.).
• Specifically addresses questions in a solicitation that address how MedImpact supports the business of a potential client, or how MedImpact differs from its competitors, or similar types of solicitation questions. Insures that MedImpact aligns with the business objectives of the soliciting organization to facilitate development of a new or extended business relationship.
• Works with MedImpact Program Directors to provide information about business requirements of clients that align with both the Client’s and MedImpact’s direct state contracting business goals, specific regulated program objectives, and performance metrics when applicable.
• Recommends areas within MedImpact operations, and/or product/program process flows for investigation of workflow/documentation improvement.
• Participates in approved/designated EPP projects focused on MedImpact direct state contracting initiatives identified through business development opportunities that are presently not MedImpact clients.

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.

Education And/or Experience

BA/BS Degree; 10+ years related experience and 8+ years of SME in respective area(s); (or equivalent combination of education and experience) with at least 4+ years leading individual contributors and leaders of leaders; which may be substituted with an appropriate mix of leadership experience and 5 years of MedImpact experience plus an appropriate external leadership training program and internal mentorship with a seasoned leader (VP+ level) that must completed within 12 months in new position.

Computer Skills

Working knowledge of Microsoft Office/Outlook, industry-related databases, and use of the internet.

Other Skills And Abilities

None Required. Licensed Pharmacist in CA or equivalent preferred.

• Practical working knowledge of State Medicaid FFS programs, Federal Employee Programs, State Employee programs, Medicaid, CHIP, PIHP, PAHP, PCCM, HIO, Dual Eligible, Part D, Exchange, Basic Health Plans, SNP
• Strong familiarity with the government regulatory/compliance environment and current industry trends
• Expert knowledge of the industry’s concepts, practices, and procedures.
• Proven ability to influence and work cross-functionally across an enterprise.
• Leadership style that promotes innovation and collaboration and fosters commitment.
• Strong analytical and critical thinking skills. Must possess strategic agility and effective communication skills.
• Strong public speaking abilities, communication (verbal and written) skills, interpersonal skills, and organizational skills.
• Ability to scan and anticipate policy, regulatory and legislative activity for upcoming issues that may impact the industry
• Prefer candidate to have a good understanding of operational and administrative areas of MedImpact that impact the business requirements.

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 work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry.
• Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

Language Skills

• Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
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• Ability to read, analyze, and interpret the most complex documents.

Competencies

To perform the job successfully, an individual should demonstrate the following competencies:

• Business Acumen
• Directing Others
• Organizational Agility
• Conflict Management
• Drive for Results
• Political Savvy
• Customer Focus
• Innovation Management
• Strategic Agility
• Decision Quality
• Managerial Courage

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 hear. The employee is regularly 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 25 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.

This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic).

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.

Working Hours

This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and reasonable meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm.

Travel

This position requires domestic travel of up to 50% of the time.

The Perks

• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• Incentive Compensation
• 401K with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/Veterans

Osha/Ada

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed 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.

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.