Summary
 

Leads and directs Pharmacy benefit sales activities, requests for proposals, group presentations, and consulting activities for existing and prospective employer groups. Oversees Pharmacy Benefit Manager (PBM) service agreement including performance of delegated services. Responsible for generation of pharmacy benefit quotes and maintains employer group pharmacy services agreements. Monitors PBM contract performance with respect to financial terms, federal and state regulations, and performance guarantees.

Description
 

Conducts contract negotiations. Monitors competitor sales activities and develops our message to counter their sales. Secures competitive network discounts, various network options, pricing arrangements, and solicits and analyzes bids periodically in order to remain competitive in the marketplace.

Manages pharmacy sales activities to ensure retention and growth of covered pharmacy lives. Analyzes pharmacy data and market trends to develop a pharmacy sales approach. Responds to requests for proposals, gives sales presentations and works with groups in a consulting role.

Oversees the management of the PBM contracts to ensure compliance with the terms of the PBM agreement for all lines of business. Conducts audits. Ensures compliance with state and federal requirements.

Provides recommendations for the development of additional PBM programs based on market needs.

Works closely with actuarial and underwriting departments in pricing products.

Required Education: Bachelor's in a job related field

Required Work Experience: 10+ years of progressively complex healthcare network development experience to include 2 years of pharmacy contracting experience and either 7 years of management experience in negotiating and maintaining network contracts OR 7 years of equivalent military experience in grade E4 or above.

Required Skills and Abilities: Excellent verbal and written communication skills. Excellent customer service, organizational, and presentation skills. Excellent analytical and critical thinking skills. Proficiency in spelling, punctuation, and grammar. Ability to persuade, negotiate, or influence others. Ability to use complex mathematical calculations. Ability to meet tight deadlines, and adapt to an ever-changing business environment. Able to quickly implement new business requirements without disruption of current responsibilities. Ability to assess both internal and external requirements and reprioritize quickly. Ability to oversee multiple projects simultaneously.

Required Software and Other Tools: Microsoft Office. Knowledge of computer systems support and data extracting.

Preferred Education: Bachelor's degree-in Business Administration.

Preferred Work Experience: 8 years-of operations or contracting experience with Medicare Part D, analyzing pharmacy claims data. Experience may also be in PBM implementation and contract compliance experience.

Preferred Licenses and Certificates: Registered Pharmacist

Work Environment: Typical office environment. Frequent travel.

 

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Some states have required notifications. Here's more information. 

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail [email protected] or call 1-800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.