Job Abstract

Resp & Qualifications

Although this position is REMOTE, candidates MUST live in the MD, DC, VA , PA, DE and surrounding areas in order to travel to offices and client meetings.

PURPOSE:

The Manager, Specialty Pharmacy Financial Value & Solutions is responsible for the oversight and execution of strategic plans and financial operations for the Pharmacy business. This strong leader will cultivate portfolio insights, develop the business line strategy, and deliver a collaborative value chain to internal and external customers. Working collaboratively with Sales, Underwriting and Pharmacy Operations, this leader will utilize their expertise to deliver growth and profitability results, drive membership and serve as the Pharmacy Subject Matter Expert.

Under the direction of the Director, Pharmacy Financial Value & Solutions, this individual will provide recommendations for product, and service improvements, and actively partner with Sales, Underwriting and Account Management in selling/retaining Pharmacy Business.

ESSENTIAL FUNCTIONS:

• Manages and coaches support staff on vision, priorities, projects, and individual performance and development. Continually reviews staffing requirements and makes recommendations as needed for additional support. Makes decisions regarding hiring, promotion, and development.
• Manages the ASO Credit Fund working collaboratively with PBM, Sales, Underwriting and Finance optimize the annul fund amount in order sell new pharmacy business and retain existing pharmacy business.
• Manages the updates to the pricing monitor tool and provides training when needed.
• Manages required reporting to for Commercial and Government Program lines of business collaborating with internal and external business partners.
• Manages the completion and updating of SOPs for the Pharmacy Value Solutions team when needed.

SUPERVISORY RESPONSIBILITY:

This position manages people.

QUALIFICATIONS:

Education Level: Bachelor's Degree in Business Administration or related field OR in lieu of a bachelors degree, an additional 4 years of relevant work experience is required in addition to the
required work experience.

Licenses/Certifications:

• Current Health & life license for any of the CareFirst jurisdictions (Maryland, DC and/or Virginia).

Experience:

• 5 years in the operations, audit, or sales discipline with an emphasis on strategy.
• Minimum 3 years supervisory or demonstrated progressive leadership experience.
• PBM experience is highly preferred!

Preferred Qualifications:

• Experience in a sales/consultant/ underwriting / operational position with a competitor or another Blue Cross Blue Shield plan is preferred.
• Experience as an Actuary in Pharmacy Financials & Pharmacy Analytics

Knowledge, Skills and Abilities (KSAs)

• Advanced and in-depth knowledge of (Specialty) Products.
• Previous experience developing value propositions, gathering insights, and analyzing market trends.
• Strong collaboration, conflict resolution and influencing skills.
• Experience building and managing cross functional teams in a matrixed environment.
• Strong presence and the ability to interact across all levels of the organization.
• Must be able to meet established deadlines and manage multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Salary Range: $111,040 - $206,118 (salaries are based upon education, experience and internal equity)

Travel Requirements
Estimate Amount: 10% Local travel may be required. Must have independent transportation to travel to other locations in the mid-Atlantic region.

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Department

Rx Value Solutions

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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