Principal State Medicaid FFS Operations

Exemption Status:

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing
solutions
that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Principal State Medicaid FFS Operations

$97,382 - $133,900 - $170,418

Summary:  The role of the Principal, State Medicaid FFS Pharmacy Operations focuses on business development in order to forge strong executive relationships with clients and potential clients. Additionally, this position identifies areas within the business that can be optimized, streamlined, and improved in order to differentiate product offerings and increase revenue for the Company.  

Essential Duties and Responsibilities, and other duties as assigned:

• Leads project teams to exceed State Medicaid Fee-For-Service program requirements and expectations

• Supports business development activities to enable the company to grow and retain clients in its State Medicaid FFS business. Serves as a company representative to key government customers and prospects

• Business development and on ongoing relationship management primarily focused on developing strong executive (C-suite) level relationships with Managed Care Organizations (MCOs) and State fee-for-service (FFS) executive leaders that are current or future MedImpact direct state contracting clients.  

• Develops relationships by building trust and gaining knowledge of the business requirements of the organization. 

• Interacts with applicable internal business development staff to develop solicitation strategies, identify business requirements, and lends support to the sales cycle when applicable.  

• Identifies areas (operational, administrative, process, reporting etc.) enterprise-wide where improvements would enable the enterprise to improve delivery of a differentiated business proposition to potential and current clients.  These areas would drive increasing revenues or improved enterprise efficiencies (less error, less liability, improved operational process flows, enhanced data capture and interpretation, improved management oversight, etc.). Efficiencies will increase the potential for new MCO, FFS, or other Regulated Programs to select MedImpact as its PBM.

• Assists with developing and implementing short- and long-term strategies to gain access to State FFS leadership for purposes of increasing new Regulated Program business for MedImpact.  These strategies may include:
  • Focused messaging 
  • Networking opportunities (conferences, speaking opportunities, state specific Medicaid leadership meetings) independent of and in coordination with MedImpact Sales & Account Management activities
  • Geographic targeting and new client opportunity strategy in coordination with MedImpact Sales & Account Management teams.
  • Consultant strategy
  • Warm referrals from networked individuals or leaders

• Gains appointments with non-MedImpact clients (stand-alone Medicaid Agencies  or multi-LOB opportunities where one or more of their products focus on and include Medicaid coverage) at the executive level (C-Suite), or with Regulated programs where there is a potential for a PBM solicitation, or with a key designated consultant.

• Develops relationships with potential non-MedImpact client leadership to further understand their businesses and business requirements while also imparting an agreed upon MedImpact message or messages.  Builds trust to the point that these leaders or their designated staff would attend MedImpact sponsored activities (program WebEx’s, client conference, receipt of marketing materials etc.).

• Specifically addresses questions in a solicitation that address how MedImpact supports the business of a potential client, or how MedImpact differs from its competitors, or similar types of solicitation questions.  Insures that MedImpact aligns with the business objectives of the soliciting organization to facilitate development of a new or extended business relationship.

• Actively participates in “Best & Final”, “Orals”, or vendor finalist presentations to organizations where a previous relationship is established. 

• Works with MedImpact Program Directors to provide information about business requirements of potential clients that align with both the Client’s and MedImpact’s direct state contracting business goals, specific regulated program objectives, and performance metrics when applicable.

• Recommends areas within MedImpact operations, and/or product/program process flows for investigation of workflow/documentation improvement.

• Participates in approved/designated EPP projects focused on MedImpact direct state contracting initiatives identified through business development opportunities that are presently not MedImpact clients.  

Education and/or Experience

Bachelor’s degree required (or equivalent combination of education and experience), advanced degree preferred (Pharm.D., Ph.D., MBA, MS, MPA, MPH), along with 10+ years’ related progressive experience in healthcare related Pharmacy Benefit Management/Administration Organizations, or as a pharmacist at a Deputy Chief or equivalent level at a State Medicaid Agency.  Must  in-depth knowledge of governmental programs (CMS, Medicaid, Medicare, and Market Place).

4 years of supervisory experience required. Supervisory experience may be substituted with 5 years of MedImpact experience plus an external leadership training program and internal mentorship with a seasoned leader (VP+ level) that must completed within the first 12 months in the new  position.

Certificates, Licenses, Registrations

None Required. Licensed Pharmacist in CA or equivalent preferred.

Other Skills and Abilities

• Practical working knowledge of State Medicaid FFS programs, Federal Employee Programs, State Employee programs, Medicaid, CHIP, PIHP, PAHP, PCCM, HIO, Dual Eligible, Part D, Exchange, Basic Health Plans, SNP
• Strong familiarity with the government regulatory/compliance environment and current industry trends
• Expert knowledge of the industry’s concepts, practices, and procedures.
• Proven ability to influence and work cross-functionally across an enterprise.
• Leadership style that promotes innovation and collaboration and fosters commitment.
• Strong analytical and critical thinking skills.  Must possess strategic agility and effective communication skills.
• Strong public speaking abilities, communication (verbal and written) skills, interpersonal skills, and organizational skills.
• Ability to scan and anticipate policy, regulatory and legislative activity for upcoming issues that may impact the industry
• Prefer candidate to have a good understanding of operational and administrative areas of MedImpact that impact the business requirements.  

The Perks:

• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• Incentive Compensation
• 401K with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego,
California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/Veterans

OSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above
statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.