Principal, Preferred Drug List & Supplemental Rebate Operations

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

• Oversight and management of the evolution of the entire solicitation, bidding, negotiation and contracting processes and tools related to supplemental drug rebates, including but not limited to all services, deliverables, and oversight of both internal and subcontractor operations. This includes oversight of related PDL development and maintenance as well as collaboration with the drug manufacturer invoicing team and rate-setting team.
• Responsible to work with and oversee a diverse set of professionals to fulfill contract requirements, including oversight of any subcontracts and their performance.
• Provides recommendations, working with the assigned Clinical Program Managers (CPMs) to assigned clients that align with the clients’ goals of lower net costs and high clinical quality. The strategic recommendations include benefit design and Preferred Drug List (PDL) analysis and suggestions, provision of clinical drug information, utilization management criteria development, P&T support and participation, recommendations for rational drug PDL positioning, on-line system edits and restrictions, on-going clinical product evaluations, and recommendations regarding client pharmacy benefit utilization and performance trends.
• Provide Medicaid clinical and operational consultative services in accordance with contracted clinical and consultative services working with each clients CPM.
• Identify and promote MedImpact’s evidence-based interventions and communication programs to clients. Working with the SMEs and CPMs, provide documentation of recommendations for clinically appropriate and financially beneficial clinical initiatives (e.g. rebate enhancement, lower net cost, generic programs, QA programs).
• In concert with the client CPMs and the GPS Medical Director recommend clinically appropriate PDL changes considering factors such as lowest net cost after rebates, market shifts, and utilization to develop optimized PDL solutions.
• Contribute to the analytical and clinical support of Preferred Drug Lists.
• Participate in state P&T meetings as per client contract and need.
• Manage and develop the personnel and infrastructure needed to support and evolve the Company’s Medicaid FFS supplemental drug rebate program.
• Actively participates in, manages and oversees Medicaid supplemental rebate negotiations.
• Develop and provide fiscal projections for various supplemental rebate and PDL strategies that incorporate clinical and fiscal determinants.
• Consideration and negotiation for value-based contracts.
• Collaborate with internal partners to lead in the identification, documentation, and development of business and system requirements necessary to support the supplemental rebate program and processes.
• Work with cross-functional subject matter experts in IT, analytics, operations, and sales to support MedImpact’s emerging Medicaid FFS product line.
• Research new program offerings and enhancements related to both supplemental and federal rebates and related PDL activities.
• Make recommendations for specific state program improvements based on program performance analytics and utilization trend data.
• Collaborate with the Rebate Operations Director and GPS Medical Director on new implementations to ensure that supplemental and federal rebate files and data are complete and tested for validity.
• Work with reporting team to develop and deploy accurately configured standard and state specific PDL related and supplemental rebate reports and provide guidance to state resources as necessary to generate ad-hoc reports using MedImpact reporting and analytics tools.
• Resolve escalated issues regarding state Medicaid supplemental drug rebate programs.
• Define/manage all aspects of assigned projects to ensure completion that meets defined scope, quality, and time constraints.
• Support internal and external state audit preparation and execution.
• Keep up to date with industry changes and best practices.
• Actively participates in sales activities related to supplemental rebate operations including participation in site visits, demos and proposal development.
• Develop and implement processes to keep internal/external customers up to date on: (1) changes made by manufacturers, (2) specific states’ requirements, (3) CMS, and (4) MedImpact rebate processes and policies that impact the rebate program and related activities.
• Develop models that enable assessment of the impact of changes recommended to clients.
• Understand and interpret customer fiscal and operational needs in support of MedImpact business goals and retention planning for each state contract.
• Oversee specified state client contracts to ensure all state/federal deadlines are met and customer satisfaction is met or exceeded.
• Attend specific state-focused internal and external meetings to address all topics and concerns.
• Develop good working relationships with internal and external stakeholders; communicate with clients professionally and proactively responds to inquiries.
• Attend identified conferences and sales meetings.

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; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; 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

PharmD Degree; 8+ years related experience and 8+ years of SME in respective area(s); (or equivalent combination of education and experience) with at least 4+ years leading individual contributors and leaders of leaders; which may be substituted with an appropriate mix of leadership experience and 5 years of MedImpact experience plus an appropriate external leadership training program and internal mentorship with a seasoned leader (VP+ level) that must completed within 12 months in new position.

Computer Skills

To perform this job successfully, an individual should have knowledge of Microsoft Office Suite and experience with at least one business intelligent tool (IBM Cognos or Tableau preferred).

Certificates, Licenses, Registrations

Registered Pharmacist license in good standing and the ability to obtain licensure in specific state as necessary within 6 months.

Other Skills and Abilities

• Experience with direct supervisory responsibilities of pharmacists, technicians, and analysts preferred.
• Must have prior experience and in-depth understanding of (1) CMS Medicaid Drug Rebate Program, (2) state supplemental rebate programs, (3) drug pipelines, (4) pharmaceutical manufacturing industry, (5) state fiscal planning and reporting, and (6) clinical value of medications.

Reasoning Ability   

• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.

• Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems. 

Mathematical Skills

• Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

Language Skills

• Ability to write reports, business correspondence, and procedure manuals. 

• Ability to effectively present information to top management, public groups, and/or boards of directors.

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