Supervisor, Formulary 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

Essential Duties and Responsibilities include the following. (Other duties may be assigned.)

• Manages, mentors, and provides supervisory guidance and oversight to formulary administration specialists;

• Oversees the staff that manages the operational formulary processes, configuration and implementation activities for all Commercial, Part D, Medicaid, and Marketplace lines of business and Enterprise Formulary System. This includes technical and workflow support, intake assessment and assignment, and quality review of formulary work product prior to implementation and client distribution.

• Coordinates inter and intra-departmental and external inquiries and requests surrounding the past plan year audits, the current plan year maintenance and the future plan year build concurrently;

• Provides formulary-specific documentation of maintenance activities to clients and regulatory bodies as appropriate. Ensures compliance with policies and procedures and how-to guides for Formulary Administration and Strategy ;

• Maintain and update policies and procedures

• Maintain and update job aids for Formulary Administration Specialists

• Manages and contributes to current priority projects, programs, or initiatives as defined by leadership. Coordinates inter and intra-departmental project activities and groups as necessary to meet project goals and timeframes;

• Provides direct client consultation on designated Formulary Administration and Strategy formulary maintenance operations, programs, and software;

• Assists in the delivery of appropriate, accurate, and consistent client specific formulary claims adjudication, formulary flat files, Plan Finder file, and other related program materials.

• Responsible for accurate and timely task estimation and status reporting to Formulary Administration and Strategy  management. Executes within the confines and timeframes provided by CMS which may include non-standard business hours.

• Other reasonable tasks related to this job or to tasks in other departments that may be within the individual’s skill set, as needed by management.

Supervisory Responsibilities:

Directly supervises assigned staff in the Formulary Administration and Strategy department. Position performs 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.

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.

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; Respond promptly to client needs; Solicits client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients; Manage difficult or emotional client situations.

Education and/or Experience:

Bachelor’s degree from a four-year college or university and over 2 (two) years related pharmacy benefit management or healthcare experience and/or training; or equivalent combination of education and experience. One year of supervisory experience required or 2 years MedImpact experience can be substituted for the supervision experience requirement plus an appropriate external leadership training program  and internal mentorship with a seasoned leader at the Director level of above to be completed within 12 months in the new position. 

Computer Skills:

To perform this job successfully, an individual should have knowledge of the entire Microsoft Office Suite of software tools as well as knowledge or ability to learn to use MedAccess and claims adjudication logic.

Certifications, Licenses, Registrations:

Pharmacy Technician license or equivalent experience. 

Other Skills and Abilities:

• Prior experience in PBM formulary setup and maintenance, relational and analytical database management programs required.
• Laker platform experience required
• Must be able to execute and deliver within the confines and timeframes provided by CMS and the State government entities which may include non-standard business hours.
• Advanced Drug Information experience preferred.

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 calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, ratios, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.

Language Skills:

Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or government regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and general public.

Competencies:

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

• Problem Solving – Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics.

• Oral Communication – Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.

• Written Communication – Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.

• Managing People – Includes staff in planning, decision-making, facilitating and process improvement; Takes responsibility for subordinates’ activities; Makes self available to staff; Provides regular performance feedback; Develops subordinates’ skills and encourages growth; Solicits and applies customer feedback (internal and external); Fosters quality focus in others; Improves processes, products and services; Continually works to improve supervisory skills

• Strategic Thinking – Develops moderate strategies to achieve organizational goals; Understands organization’s strengths and weaknesses; Identifies external threats and opportunities; Adapts strategy to changing conditions.

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 and talk or listen. The employee is occasionally required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 35 pounds.

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.

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.