Principal, Formulary and Rebate Optimization-1

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

Essential Duties and Responsibilities include the following:

• Proactively identifies, develops, and executes initiatives which optimize rebate yields and administrative fee revenue through an array of channels and processes, which includes developing and delivering value proposition statements (financial and clinical) with respect to rebate and formulary alignment opportunities to internal and external stakeholders who are responsible for formulary placement decisions.
• Works independently and in collaboration with Pharmaceutical Manufacturers in order to develop and implement processes, products, and methods which support rapid utilization conversions following formulary placement changes to quickly optimize rebate production.
• Serves as an internal and external subject matter expert to the company and client plans related to contractual rebate terms, conditions, requirements, interpretation, compliance and overall rebate strategies; individually responsible for direct communications and relationships with high profile and strategic clients to educate, inform, recommend and persuade these clients to adopt changes that drive rebate yields.
• Communicates tactical solutions to optimize rebate yield and reduce drug spend through a combination of formulary management techniques and pull-through initiatives to stakeholders throughout the enterprise (including Formulary Services and Drug Information) as well as to rebate clients in coordination with Account Management teams.
• Responsible for rebate, net spend, and disruption modeling using direct and external rebate contract terms and client utilization, and for presentation of modeling results and recommendations to clients and account teams. Responsible for rebate performance and trending analysis for internal and externally sourced rebates and administrative fees.
• Develops strategic and tactical solutions in coordination with the Director, Industry Relations and with the Formulary Business Review Committee to optimize rebate yield and reduce drug spend through a combination of contract design and coordinated execution of formulary management and clinical / utilization edits for all lines of business (Commercial, Medicare, Medicaid, Health Exchange).
• Develops strategic and operational solutions for Risk Based Contracting and other innovative contracting initiatives in support of emerging rebate propositions.
• Manages “Formulary and Rebate Optimization” staff to achieve established unit and company goals and objectives.
• Collaborates with Rebate Operations management to evaluate of contract rebate eligibility qualifications with respect to each individual client plan for purposes of rebate qualification and calculation, supporting quality assurance efforts to ensure accurate rebate billing, collaborating with account management teams to support rebate initiatives, and other activities supporting the contracting strategy, implementation and performance.
• Supports other departments throughout the company through establishment and cultivation of opportunities related to Pharma supported initiatives such as Medical Management coordination, aligning Patient Care Center initiatives, executive business briefings, communication and coordination of LDD distribution channels, member support programs involving Centers of excellence, pharmacoeconomic analysis projects, etc.
• Actively participates in the formulary strategy development process with respect to formulary management opportunities that improve rebate yield and drive lower net costs for clients for MedImpact Standard formularies operating under direct and indirect rebate agreements. Participates in the Formulary Business Review Committee with the responsibility to generate recommendations for consideration by the committee with respect to MedImpact Standard Formulary changes as well as with aligned clients managing custom formularies, and to facilitate the implementation of approved formulary changes with pull-through support.
• Coordinates with subsidiary and related companies with respect to Industry Relations strategies to enhance and optimize value creation across the enterprise.
• Participates as a Subject Matter Expert (SME) member of the Formulary Committee, providing support of Formulary Committee product placement considerations through financial spend/utilization/rebate models, proposing formulary management recommendations for individual drugs and therapeutic classes, sharing market intelligence and industry analysis to assist in understanding the current and future drug marketplace, and contributing to the concepts and features associated with the overall formulary strategy intended to achieve corporate objectives of optimal rebate performance.
• Participates and leads the annual Part-D formulary strategy process with respect to formulary product placement opportunities that improve rebate yield and drive lower net costs for clients.
• Supports audits of rebates conducted by clients, pharmaceutical manufacturers, and CMS in terms of providing interpretation of Rebate contract language as it applies to individual client formularies.

Supervisory Responsibilities

Manages assigned staff in the segment area. Responsible for the overall direction, coordination, and evaluation of the unit. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Supports and enforces all company policies and procedures in a fair and consistent manner, taking corrective action whenever necessary.

Client Responsibilities
This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to manage difficult or emotional client situations, solicit client feedback to improve service, respond promptly to requests for service and assistance from clients and meet commitments to clients.

Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below 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.

Education and/or Experience
Doctor of Pharmacy (Pharm D.) from an accredited School of Pharmacy and a Pharmacy Residency along with 5 - 10+ years’ related leadership experience.

Computer Skills
To perform this job successfully, an individual should have a strong competence with Microsoft Office (Word, Excel, Access and PowerPoint) software. The individual is expected to develop competence with Cognos or other business intelligence software, as well as with proprietary MedImpact systems such as MedAccess and other systems/databases used by MedImpact.

Certificates, Licenses, Registrations
Valid Registered Pharmacist license in any state of the US.

Other Skills and Abilities

• Superior working knowledge of all types of managed care pharmacy services with an emphasis on the relationship between managed health care and pharmacy benefit management. Expertise in the advanced application of managed pharmacy practice and managed medical and prescription drug practices.
• Good working knowledge of all types of pharmacy services, with an emphasis on the managed health care environment.
• Expertise in administrative and operational application of pharmacy practice.
• Excellent verbal and written communication skills with ability to persuasively present business propositions in a confident, trustworthy, and clear manner.
• Ability to dynamically identify challenges and creatively develop solutions using a consultative sales approach.

Reasoning Ability
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Mathematical Skills
Ability to work with mathematical concepts such as probability and statistical inference. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

Language Skills
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of senior level executives, clients, customers, and the general public.

Competencies
To perform the job successfully, an individual should demonstrate the following competencies:

• Business Knowledge - Demonstrates clear understanding of the nature of the business -- its products and services, goals, market, competitors and challenges.
• Communication -Expresses self clearly and effectively in face-to-face interactions, presentations and written documents, and employs active listening skills to ensure productive interactions.
• Decision-making - Gathers input from affected parties and available experts, assesses risks and benefits, and makes timely decisions based on sound reasoning.
• Leadership - Leads effectively by communicating long-range vision, exercising influence, building strong teams, mentoring and motivating others, and upholding corporate responsibility.
• Management - Manages for results, delegates skillfully with appropriate follow-up, manages change processes, employs effective negotiation skills, and uses sound strategies for decision-making and problem-solving.
• Strategic Vision - Formulates and communicates a long-range, big-picture vision, taking into account both opportunities and challenges, and translates that vision into specific action steps.
• Team Leadership - Fosters teamwork by clearly communicating goals and direction, building team spirit, encouraging positive working relationships, and encouraging individuals to take on new roles that draw fully on their talents.

Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is frequently required to reach with hands and arms. The employee is occasionally required to stand and walk. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, color vision and ability to adjust focus.

Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Working Hours
This is an exempt level position requiring one to work the hours needed to get the job done. Therefore one must have the flexibility to work beyond traditional hours. Typical core business hours are Monday through Friday from 8:00am to 5:00pm.

Travel
This position may require domestic and international travel. A valid passport and ability to leave the United States is required.

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.