Company :Highmark Inc.
Job Description :
This job will provide direction and oversight to staff members for the end-to-end management of Highmark’s traditional and innovative drug rebate contracts for activities including contract negotiation, financial modeling, contract execution, rebate invoicing and vendor oversight (as applicable). Serves as primary contact with pharmaceutical manufacturers and key vendors, including Pharmacy Benefit Manager. Engages with internal and external stakeholders to execute Highmark’s drug contracting strategies and drive to low-net cost medication benefit offerings for customers. Oversees relationships with external client plans as part of Highmark’s medical drug rebate administration program. Responsible for departmental compliance with contractual obligations and rebate administration for both Highmark and external client plans.
- Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
- Direct and lead staff members in negotiating and executing drug rebate contracting strategies, which reduce spend and administrative costs and maintain a competitive position for Highmark’s benefit products. Manages relationships with key internal and external stakeholders to develop and execute Highmark’s strategic drug rebate portfolio across pharmacy and medical benefits. Directs end-to-end strategic and operational process for managing traditional and innovative drug rebate contracts including contract negotiations, execution, invoicing and vendor oversight (as applicable).
- Oversees relationships with external client plans as part of Highmark’s medical drug rebate administration program. Support external client plans in obtaining medical drug rebate opportunities aligned with their plan’s drug management strategies and philosophies Direct staff members responsible for executing strategic and operational components of medical and innovative drug rebate contracts for external client plans.
- Oversee relationship with Highmark’s Pharmacy Benefit Manager engaged to provide pharmacy benefit drug rebate administration services. Collaborate with Clinical Pharmacy team during formulary management discussions to highlight the net financial impact of proposed formulary changes while supporting Highmark’s clinical-first drug management philosophy.
- Ensure compliance with government drug rebate reporting obligations of Highmark and any vendors (as applicable). Responsible for oversight of audit response from internal and external entities as related to drug rebate contracts.
- Direct and provide oversight to staff and assist with planning and assigning projects to other staff members. Including but not limited to: Provide project lead instruction and direction to other staff regarding solutions to: meet business issues; Negotiate project deliverables: Anticipate impact and propose solutions; Research and analyze complex operational business processes or system applications; Adherence to standards/procedures to include obtaining pre- and post-implementation sign-offs.
- Promote a culture of performance excellence departmentally by: Directing and encouraging quality process improvement and tools training/certification; Encouraging staff members to build and maintain effective relationships throughout organization to advance performance excellence.
- Communicate effectively with all levels of the organization. Direct and encourage staff members to communicate effectively with all levels of the organization. To include: Identifying and articulating problems to senior management, steering committees and/or project sponsors; Developing business solutions to satisfy complex project goals and objectives; Conducting problem solving resolution and decision-making sessions for complex issues and projects; Establishing and maintaining customer touch points.
- Other duties as assigned or requested.
- Bachelor's degree in Business, Healthcare or related field
- Master's degree in Business, Healthcare (i.e., PharmD) or related field
- 5 years in a drug rebate contracting process
- 5 years in a Health Plan, Pharmacy Benefit Manager (PBM) or Pharmaceutical Manufacturer environment
- 3 years in leading a strategic function within a managed healthcare environment (e.g., health plan, PBM)
- 1 year in an external customer-facing role
- Experience leading pharmaceutical manufacturer rebate negotiations and contracting strategy
- Experience in a Health Plan or PBM pharmacy department supporting strategic care cost savings initiatives
- Registered pharmacist or Pharm D
LICENSES or CERTIFICATIONS
- MS Office proficiency
- Excellent verbal and written communication skills
- Strategic thinking skills
- Relationship- building skills
- Analytic and business solutioning skills
Language (Other than English):
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Teaches / trains others regularly
Travel regularly from the office to various work sites or from site-to-site
Works primarily out-of-the office selling products/services (sales employees)
Physical work site required
Lifting: up to 10 pounds
Lifting: 10 to 25 pounds
Lifting: 25 to 50 pounds
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:$92,300.00
Pay Range Maximum:$170,800.00
Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
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