Vice President Pharmacy Health Plan
Company: Baylor Scott & White Health
Location: Temple
Posted on: February 21, 2021
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Job Description:
JOB SUMMARY: Responsible for the strategic direction, growth,
and profit and loss for the Health Plan pharmacy annual spend as
well as the outsourced Pharmacy Benefits Manager (PBM)
relationship. Leads a multi-disciplinary team and partners with
clinical leadership to drive an integrated pharmacy and medical
management model that will continue to reshape the care delivery
system and improve health of the SWHP members. JOB FUNCTIONS:
Provides strategic direction and guidance on all pharmacy
initiatives. Lead the development and implementation of annual and
multi-year strategic planning processes for the pharmacy operations
function. Ensure regulatory compliance by leading and developing
medication safety and compliance programs. Deliver and exceed
profitable growth objectives for the Pharmacy Business. This
includes revenue, expense management, rebates and total net
earnings. Oversee the Pharmacy Benefit Manager (PBM) relationship;
ensure market competitive PBM and Specialty Pharmacy results while
focusing on developing long-term value for customers through
clinical pharmacy program innovation. Influence members and
provider desired behaviors through incentives, formulary, and
benefit design. Oversee and directs the development,
implementation, and administration of pharmacy programs in
alignment with System strategies. Develops and maintains cost
effective pharmacy programs utilizing formulary management to
increase medication compliance and ensure appropriate member care.
Leads the development of new models of pharmacy and medication
integration. Lead the assessment of current pharmacy benefits in
collaboration with internal departments; provide expertise to
internal departments and external stakeholders on benefit design.
Anticipate and discuss the impact of large-scale trends, and
properly position or reposition the pharmacy business
appropriately. Develop and assess metrics to evaluate program
performance. Identify and implement industry best practices to
optimize performance. Ensure the integration of the pharmacy line
of business in the Health Plan''s care models and member engagement
strategies. Develop a consistent approach to supporting sales and
retention of pharmacy benefits customers, working collaboratively
with Health Plan business partners. Analyze clinical individual and
population data, drug program data, and drug therapy data.
Integrate the clinical, administrative, and business policies and
procedures of the pharmacy department in order to facilitate
patient-centered care for members through effective collaboration
with internal departments. Develop and ensure adherence to goals
and deadlines for the Pharmacy department. Oversee the work of the
pharmacy staff. Provide strategic leadership and direction to
management including performance management oversight and employee
development. Knowledge, Skills and Abilities Demonstrated knowledge
of pharmacy benefit management, and the broader ecosystem of
managed care, including prescription drugs, pharmacy benefits
design, utilization review, cost containment strategies, formulary
management and emerging technology. Strong financial acumen and
experience leading large P&Ls equivalent in size to the Health
Plan''s pharmacy business. Strong business acumen with ability to
evaluate, tailor and develop integrated pharmacy programs. A highly
articulate communicator and compelling leader who can communicate
the Health Plan''s vision and value proposition to internal and
external constituents. Experience and understanding of how to work
within a complex business model to deliver a total value
proposition, and experience navigating through matrix
organizational structures. Strong strategic thinking; able to
develop a clear and compelling vision and strategy and translate
into goals and measurable results. Ability to motivate, lead and
inspire a diverse group to a common goal/solution with multiple
stakeholders and work collaboratively to develop solutions. A
purpose-driven self-starter who is comfortable managing through
ambiguity; possesses creativity and drive to solve complex
problems. Knowledge of state and federal laws as applicable to the
health insurance industry and PBM industry. The ability to attract,
recruit and retain top talent, motivate the team, delegate
effectively, celebrate diversity within the team, and management
performance; widely viewed as a strong developer of others.
Bachelors degree in Pharmacy or related field.Doctorate of
Pharmacy, preferred.Ten or more years pharmacy experience
preferred,with a minimum of 8 years of management/team leadership
experience.by Jobble
Keywords: Baylor Scott & White Health, Temple , Vice President Pharmacy Health Plan, Executive , Temple, Texas
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