Position Description:
At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”
The VP Pharmacy Strategy & Services will lead a team that consults with our customers to help them develop and implement strategic pharmacy solutions that will allow them to access highly effective treatments at a reasonable and affordable cost. Work with internal staff, customers and brokers to craft successful responses to pharmacy RFPs and other new business opportunities. Drive strategies to create new pharmacy pricing and service models. Drive initiative and creativity to provide solutions to support business objectives, e.g., new products, programs, services, training, in order to deliver value to stakeholders and customers and enhance market competitiveness.
Responsibilities and Qualifications:
- 30% - Lead a team that consults with customers to help them develop and implement strategic pharmacy solutions that will allow them to access highly effective treatments at a reasonable and affordable cost. This will include creating new pharmacy pricing and service to guide customers in making good decisions on effective pharmaceutical usage.
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15% - Lead staff that respond to requests for proposal (RFP), ensuring accurate and timely response to business bids, with expertise in self insured ASO revenue opportunities.
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20% - Oversee pharmacy product and program development and initiatives, including evaluation of business partnerships and ventures. Including generation of new product ideas; facilitation of multi-disciplinary group through concept generation to development formulary enhancements and analytics.
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15% - Foster relationship with PBM, driving accountability for financial and operational performance requirements and guarantees.
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10% - Oversee the development, coordination, and presentation of training programs for both internal and external audiences / customers. This will include helping customers understand and manage their pharmacy utilization.
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10% - Oversee the research and assessment of corporate projects, from product strategy through implementation hand-off. Manage assigned projects with project management methodology along with building and leading effective work teams, and using innovative solutions to meet or exceed established goals and objectives.
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Independent, proactive thinker with capability to bring new ideas that compliment product portfolio and corporate strategies.
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Strong ability to simply articulate concepts and ideas and convey those to customers will be necessary.
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Ability to manage multi-discipline teams to achieve results.
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Adapt and willing to face changes and challenges.
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Ability to explain and persuade internal and external stakeholders on the value of different pharmacy arrangements and pharmaceuticals.
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Strong presentation and training skills to a variety of audiences and settings.
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Ability to conduct and direct research, analyze, develop, and interpret concept and assist with preparation of proposal and business plan.
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Excellent organization skills to prioritize workload, process multitasks, and manage time effectively in an ever-changing health care environment.
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Strong project management skills to manage assigned projects with detailed project plans and methodologies, effective work teams, and creative/innovative solutions which meet or exceed established project objectives.
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Leverage interpersonal relationships and team skills to negotiate and influence business and project decisions; demonstrate negotiation skill.
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Strong written and verbal communication skills, with ability to interact and maintain relationships with vendors and customers (internally and externally).
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Ability to analyze and interpret medical benefit and pharmacy benefit interrelationship.
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Ability to translate business needs into a comprehensive action plan and take the lead in its execution.
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Ability to cultivate and manage relationships at senior management levels.
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Proven to exercise sound judgment in decision-making and problem solving.
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Ability to take initiative, self-manage, and handle rapidly changing priorities with minimal supervision.
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Possess effective tact and diplomacy skills to gain commitments and build relationships in support of development efforts.
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Proficient in PC-based software packages.
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Knowledge of the pharmacy industry / practices, pricing models, pharmacy benefit vendors, managed care principles, and prescription claims processing systems
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Knowledge of PBM contracting.
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Understanding and experience in responding to request for proposals (RFP).
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Understanding of our market, the health insurance industry in general, as well as health insurance products offer.
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Understanding of regulatory environment and its restriction and applicability to the pharmacy benefit and health insurance system.
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Understanding our customer’s pharmacy needs.
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Understanding of brokers and pharmacy consultants motivations, expertise, business models and financial arrangements.
Experience:
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10 years clinical pharmacy experience.
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Experience in business planning, managing and coordinating implementation of business initiatives and corporate projects.
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Leverage experience to solve complex challenges/problems and provides guidance and solutions.
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7 years of management experience, particularly in the health insurance or pharmacy benefit manager field.
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Managed care experience and specific knowledge and training in prescription drugs, pharmacy benefits, utilization review, cost containment strategies, Medicare Part D rules and compliance requirements and emerging technology.
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Bachelor of Pharmacy degree.
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PharmD preferred.
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Current (or eligible to obtain) pharmacist license in state.
Location:
This position is classified hybrid, which requires onsite work on Tuesdays and Wednesdays.
Office setting; ability to manage timelines, effectively handle multiple priorities and work well under pressure.
While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see. The employee must be able to work over 40 hours per week. The employee must occasionally lift and/or move up to 5 pounds.
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Travel: Approximately 10% - 20%; travel to support business meetings and customer needs
About Us: We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a diverse and caring team of supportive colleagues, and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.