The Senior Director, Discount Card and Pharmacy Networks is responsible for development and management of people, policies and procedures associated with the management of WellDyne’s discount card business as well as assisting in administration of Retail pharmacy contracts, pharmacy network composition, and maintenance and reporting. The Senior Director, Discount Card and Pharmacy Networks will serve as the general manager of WellDyne’s discount card business, ultimately responsible for driving or coordinating all activities related to growth in volume, revenue and margin contribution. He or she will assist the VP, Pharmacy Network Management in developing the provider network, yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners.
Responsibilities also include establishing and maintaining strong business relationships with discount card marketers, vendors, and strategic partners, as well as Retail Chain pharmacies, Hospital on-sites, and Ancillary providers.
Essential Duties And Responsibilities
Overse all elements of discount card business development, account management, drug level pricing, operations, and reporting
Assist in creating discount card Budget and forecasting performance
Maintain contact with retail pharmacies to secure contract participation and negotiate reimbursement as well as key terms and conditions; includes inquiry and response tracking and status reporting
Develop and execute plans to ensure participating pharmacies’ compliance with credentialing requirements, and WellDyneRx’s compliance with URAC standards
Collaborate with Pricing Operations and COGS Analytics to coordinate the administration of pharmacy networks - including composition, reimbursement formulae, MAC pricing, and pharmacy transaction processing fees
Manage relationship with retail pharmacy audit partners; ensure timely exchange of data, accurate identification of auditable claims; implement processes to capture and report on client savings and WellDyne’s ROI
Lead projects focused on mitigating financial risk and increasing gross margin related to dispensing through the retail network
Maintain, and ensure adherence to, all applicable standard operating procedures relating to pharmacy network administration
Assist internal departments with claims adjudication inquiries and responses to RFP’s relating to pharmacy network administration
Hire and champion the training and development of team members
Other duties as assigned.
Education And Experience
Five plus years of full-time professional experience related to PBM, pharma, or pharmacy is required.
A Bachelor’s Degree from an accredited college or university or equivalent work experience is required.
Knowledge, Skills, And Abilities
Proficiency in drug-level pricing supporting consumer-paid business
Proficiency in contract interpretation and negotiation
Ability to support modelling of potential financial impacts of contemplated contract or pharmacy network changes
Ability to analyze and interpret performance-related data and recommend/ implement corrective action
Strong knowledge of database use and functionality
Effective Project Management ability with multiple, simultaneous projects
Ability to communicate with all individuals both internally and externally in a manner that exemplifies professionalism
Attention to detail with the ability to prioritize and meet deadlines
Must be proficient with MS Office including Outlook, Word, Excel and PowerPoint
Ability to travel up to 25% of the time to support business needs
WellDyne Can Offer You
Medical, Dental and Vision Benefits
Medical Savings Account Options with Company match
401K after 90 days of employment
Employee Assistance Program
Life and Supplemental insurance
Educational Reimbursement
Paid Time Off
Work Environment / Physical Demands
This position is in a typical office environment which requires prolonged sitting in front of a computer. Requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment including operation of standard phone, fax machine, and copier.
We are unable to consider candidates residing in Colorado, California, and New York for this particular opportunity.
EOE M/F/D/V
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Health Care Provider
Industries
Hospitals and Health Care
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