Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.
Summary
The primary responsibilities of this position are to ensure customer satisfaction, build and maintain trusting relationships with client leadership, retain clients, escalate and resolve operational issues to meet contract expectations and assure operations are aligned with organizational priorities. The position manages the relationships between all stakeholders, develops the pharmacy benefit management business, assures appropriate data evaluation and ensures financial viability. This role partners with the market health plan CEO and other internal business partners.
Your role in our mission - Serve as primary point of contact for the Ohio Single PBM
- Provide leadership throughout the Ohio PBM including strategic and operational oversight to drive operating model performance and implement strategic initiatives
- Ensures contract objectives and service levels are consistently met
- Partner with leadership team and stakeholders to define top areas for selling, general and administrative expenses and cost of service improvements and implement plans to achieve desired savings
- Oversee business intelligence across business segment to include data, analytics, and reporting requirements for new and existing operations
- Makes recommendations for improvements to meet customer expectations.
- Assures quality improvement initiatives are improving the value and cost effectiveness of PBM operations
- Leads presentations to client and makes routine client visits
What we're looking for - Bachelor's degree or equivalent combination of education and experience required
- Master's degree in Business or Healthcare Administration preferred
- Pharmacy degree and licensure highly preferred
- 5 or more years of managed care pharmacy or PBM operations leadership experience required at the director level
- Experience with end-to-end pharmacy claims lifecycle, clinical operations, call center management, medication pricing methodologies, NCPDP standards, financial management and managed care statute
- Experience evaluating healthcare data/outcomes is required
- Strong presentation, negotiation, and communication skills required
- Demonstrated leadership ability to drive results across the PBM through team influence and collaboration in a matrixed / shared service organizational model required
What you should expect in this role - This role will be onsite in Diblin, Ohio.
- Understanding of State and Federal regulations; familiarity with the requirements of accrediting organizations is required.
- Must be capable of interacting with medical specialties staff (MDs, Nurses, Care Coordinators, etc), and Pharmacy Leadership.
- Bachelor's degree or equivalent combination of education and experience required
- Master's degree in Business or Healthcare Administration preferred
- Pharmacy degree and licensure highly preferred
- 5 or more years of managed care pharmacy or PBM operations leadership experience required at the director level
- Experience with end-to-end pharmacy claims lifecycle, clinical operations, call center management, medication pricing methodologies, NCPDP standards, financial management and managed care statute
- Experience evaluating healthcare data/outcomes is required
- Strong presentation, negotiation, and communication skills required
- Demonstrated leadership ability to drive results across the PBM through team influence and collaboration in a matrixed / shared service organizational model required
What you should expect in this role - This role will be onsite in Diblin, Ohio.
- Understanding of State and Federal regulations; familiarity with the requirements of accrediting organizations is required.
- Must be capable of interacting with medical specialties staff (MDs, Nurses, Care Coordinators, etc), and Pharmacy Leadership.
The deadline to submit applications for this posting is October 30, 2024.
The pay range for this position is $127,400.00 - $182,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.