Providence Health & Services Program Director Pharmacy Contracting in Renton, Washington
Providence is calling a Program Director Pharmacy Contracting to Providence Health & Services in Renton, WA.
We are seeking a Program Director Pharmacy Contracting to be responsible for managing the Pharmacy contracts, addendums/amendments, and specialty pharmacy contract(s), including periodic Requests for Proposal and Information (RFP’s and RFI’s), contract administration, and compliance monitoring. In addition, the Program Director Pharmacy Contracting is responsible for ensuring internal compliance with contractual and regulatory requirements, evaluating the cost and feasibility of options to resolve program issues, making recommendations that meet the overall business objectives in consultation with cross-organizational business owners, and designing and implementing projects, programs, and initiatives to improve program processes to ensure compliance with contractual and regulatory requirements.
The Program Director Pharmacy Contracting is also responsible for providing Medicare and Commercial formulary support to Rebate Invoicing for drugs on each company/client formulary, to determine relative to the appropriate manufacturer contract, its eligibility for rebate invoicing.
The Program Director Pharmacy Contracting will assist the System Director, Pharmacy Services in the negotiation strategies of manufacturers. Strategies will include: procurement of product and limited supply arrangements, rebate discussions where the Pharmacy Benefit Manager has influence, formulary considerations and positioning and strategies. Account responsibilities include development of manufacturer strategy, account relationship with management, direct accountability for the Rebate contracting of the manufacturer.
Responsibilities include project scope and plan development, workgroup facilitation, status reporting, issue resolution, risk assessment/mitigation, and project administration. Interacts independently with all levels of the organization and external partners.
In this position you will :
Be responsible for the comprehensive oversight of Pharmacy Contracts, amendments/addendums, specialty pharmacy agreements, including monitoring of contract compliance, delegation of activities, and process improvements.
Demonstrate advanced understanding of business processes, internal control risk management, IT controls and related standards.
Identify and evaluate complex business and technology risks, internal controls that mitigate risks, and related opportunities for internal control improvement.
Assist with internal compliance with contractual compliance of regulatory bodies.
Facilitate and coordinate Request for Proposals and Information (RFPs and RFIs) in collaboration with appropriate subject matter experts.
Facilitate contract negotiations and renewals in collaboration with the System Director of Pharmacy Services, Department of Legal Affairs, and Chief Medical Officer (CMO).
Develop corrective action plans when deficiencies in contract compliance are identified.
Participate in new program implementations, including designing and implementing processes and initiatives in collaboration with pharmaceutical vendors.
Identify and make recommendations when opportunities for improvement in operational processes and program structures are available.
Actively participate in decision making with leadership/management team and seek to understand the broader impact of current decisions.
Generate innovative ideas and challenge the status quo.
Research innovative program development opportunities based on market trends to enhance Providence Health & Services Pharmacy program.
Facilitate use of technology-based tools or methodologies to review, design and/or implement products and services.
Responsible for all vendor reporting deliverables, including ensuring timely delivery and accuracy of reports. Consult with pharmacy purchasing agents and other content owners on accuracy of data and work with vendor(s) to correct any inaccuracies.
Understand complex business and information technology management processes.
Maintain direct account responsibilities for manufacturers and report to System Director, Pharmacy Clinical Services.
Develop manufacturer strategy, account relationship management, and rebate contracting of the manufacturer.
Provide Medicare and Commercial formulatory support to rebate invoicing on a monthly/quarterly basis for drugs on each company/client formulary, to determine relative to the appropriate manufacturer/vendor contract, its eligibility for rebate invoicing for that period.
Implement accurate pharmacy network structure and pricing for Providence Health & Services in the Pharmacy Benefits Management industry.
Review Pharmacy Benefits Management contracts and use existing business rules to implement approved pricing on multiple claims processing platforms.
Implement pricing for various offers by researching, reporting, and providing solutions to address risks.
Track project tasks and deliverables to ensure timelines are met.
Assist in the development of new reporting requirements as required for contractual and regulatory compliance.
Participate in accreditation audit activities.
Required qualifications for this position include:
This position requires a Bachelor of Science or Pharm. D. from an accredited School of Pharmacy. Pharmacy Degree is HIGHLY preferred.
A minimum of 7 years experience in either healthcare, managed care environment, pharmacy benefits management or an integrated delivery system.
Minimum 3 years Pharmacy Contract Management experience/Healthcare Administration required. (Will consider candidates who have national or regional account manager experience with strong contracting background.)
Experience in program development and/or health policy.
Experience in health care contracting.
Must have experience with having direct manufacturer discussions and demonstrated success in managing multiple manufacturer relationships.
Experience in complex contract negotiations and successful completion of contracts.
Prior experience as a licensed Pharmacist preferred.
The ability to establish and maintain confidentiality is required.
Demonstrated success in administering and overseeing high-profile contracts.
Effective collaborative and proven process improvement skills.
Strong analytical and interpersonal skills required.
Strong oral and written communication skills. Experience in business writing, including RFP’s and RFI’s and project proposals.
Solid presentation and speaking skills a must.
Ability to negotiate contracts, coordinate with key decision makers and elevate critical issues.
Pharmacy Benefits Manager and Managed Care expertise, primarily focused on the management of pharmacy budgets related to manufacturers.
Preferred qualifications for this position include:
Anticipates and takes personal responsibility for customer satisfaction.
Consistently goes out of the way to listen, understand, and support the needs of others in a sensitive manner.
Performs challenging tasks efficiently and effectively.
Anticipates problems and takes corrective action prior to completing the task.
Sets challenging objectives and works against self-defined standards of excellence to continually improve personal performance.
Demonstrated planning and project management skills.
Proven ability to set technology strategy.
- Strong attention to detail and outstanding analytical skills.
- Demonstrated management skills and ability to work effectively to build relationships with colleagues, customers, and executive management through positive interactions.
Flexibility and Response to Change
Proven ability to organize multiple projects, schedules, demand, and to meet shifting priorities.
Demonstrated ability to study, understand, adapt and respond effectively to a constantly changing environment.
Listens with sensitivity and openness.
Actively seeks constructive feedback and remains open and receptive to it.
Anticipates the information needs of others.
Proven skills in communicating with technical staff and customers.
About the department you will serve.
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence Health & Services from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We offer a full comprehensive range of benefits - see our website for details
As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.
Providence Health & Services is the third largest not-for-profit health system in the United States. Providence employs more than 76,000 caregivers (employees) across a five-state area; AK, WA, MT, OR, and CA. Our facilities include 34 hospitals, 475 physician clinics, senior services, supportive housing and other health and educational services. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Pharmacy Support
Req ID: 144000