Hybrid Principal Medicaid & Marketplace Pharmacy Operations bei MedImpact

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.

• Leads project teams to exceed Medicaid (Managed and Fee-For-Service) and Marketplace program requirements and expectations
• Supports business development activities to enable the company to grow and retain clients in its Medicaid and Marketplace 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.  
• Leverages operational-based analytics to identify 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.
• 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 Medicaid or Marketplace 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 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.  

Supervisory Responsibilities

None

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 and prospect client needs; solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients; support MedImpact’s Medicaid and Marketplace managers during implementations and operations.

Qualifications

To perform this job successfully, an individual must first have been at the leadership level at an MCO, State or PBM, and 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                                                  

• 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 or Managed Care Organizations.  Must have in-depth knowledge of governmental programs (CMS, Medicaid, Medicare, and Marketplace / Health Exchanges).
• Four (4) or more years of supervisory experience leading individual contributors and leading leaders preferred, if people leadership is required for the role which may be substituted with an appropriate mix of leadership experience plus 8 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

Solid computer skills with Microsoft Office/Outlook, industry-related databases and use of the internet.

Certificates, Licenses, Registrations

None Required. Licensed Pharmacist in CA or equivalent preferred.

Other Skills and Abilities                                              

• Practical working knowledge of Managed Medicaid, Marketplace / Health Exchange, State Medicaid FFS programs, Federal Employee Programs, State Employee programs, 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 requirement

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, and fundamentals of plane and solid geometry and trigonometry.  Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

Language Skills

Ability to read, analyze, and interpret CMS Medicare and Medicaid periodic communications, call letters, published and draft policies, regulations; other government related health plan policies and regulations as required; general business periodicals and professional journals. 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 the general public.

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

• Customer/Client Focus- Shows solid grasp of characteristics and needs of both internal and external customers, interacts directly with customers, takes personal responsibility to ensure that customers’ concerns and needs are fully understood and addressed, and follows up to ensure customer satisfaction

• Business Knowledge - Demonstrates clear understanding of the nature of the business -- its products and services, goals, market, competitors, and challenges. 

• Decision-making - Gathers input from affected parties and available experts, assesses risks and benefits, and makes timely decisions based on sound reasoning.

• Influence - Persuades others of the value of an idea or course of action, enlists cooperation and support while maintaining positive work relationships, builds consensus by communicating effectively and demonstrating an understanding of others’ positions, and effectively motivates others to buy into projects and goals.

• Results-Oriented Management - Translates vision and objectives into concrete action steps, sets priorities for use of resources by focusing on actions with optimal impact for the business, identifies obstacles to plans and takes steps to resolve them, communicates and implements realistic, effective plans with clear objectives and milestones.

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. The employee is frequently required to use hands to finger, handle, or feel and talk or hear. 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, distance vision, color vision, peripheral vision, depth perception 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.

While performing the duties of this Job, the employee is occasionally exposed to risk of electrical shock. The noise level in the work environment is usually moderate.

Work Location - This position works remote or on-site at the San Diego Headquarters or other company location. Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.

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.