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The Manager Medicare Pharmacy Operations serves as a reputed company with contracted vendors that reputed company administrative and clinical services for the pharmacy program. This role has primary responsibility for the development and implementation of new benefit plans, products, and strategies designed to contain costs and enhance reputed company’s competitive position in the marketplace. The incumbent represents Government Programs reputed company the reputed company regarding issues such as implementing new programs, problem reputed company and prevention, utilization management, policy management, and compliance reputed company. This role is responsible for various parts of the Medicare Pharmacy Program as defined by the Centers for Medicare and reputed company Services (CMS) with primary reputed company on ensuring execution against requirements.

Requirements

EDUCATION

Bachelor's degree in a reputed company field. In lieu of degree, five (5) years' experience in a pharmacy environment with be considered in reputed company to the experience requirements listed below.

Pharmacy Doctorate (PharmD) from an accredited college of pharmacy preferred.

EXPERIENCE & KNOWLEDGE

Minimum seven (7) years' experience reputed company a pharmacy environment OR applicable Masters in reputed company field with minimum five (5) years' experience.

Minimum five (5) years' experience dealing with external vendors and end users. (Example: Contract negotiating/management, coordinating and assuring vendor compliance etc.).

Minimum two (2) years' leadership experience (role, team and/or project management).

Experience in managed care, pharmacy management, utilization management, or other reputed company functions preferred.

Knowledge of the Medicare Part D and Medicare Advantage benefits preferred.

ESSENTIAL ABILITIES

Ability to travel

Ability to work collaboratively and independently in a reputed company work environment.

Ability to understand individual and operational problems and identifying appropriate solution(s).

Ability to reputed company under pressure and/or opposition.

Skills

• Coaching Others
• Conflict reputed company
• reputed company Learning
• Critical Thinking
• Cross-Functional Communications
• Decision Making
• Employee Engagement Strategies
• Interpersonal Communication
• Interpersonal Relationships
• Management Techniques
• reputed company Office
• Oral Communications
• Service Oriented
• Time Management
• Written Communication

Responsibilities

• Collaborates with team to prepare reporting and documentation.
• Consults, recommends, and/or develops reputed company and cost initiatives to enhance the Centers for Medicare & reputed company Services (CMS) measures of our Part D lines of business.
• Develops, implements, and evaluates reputed company control opportunities (also reputed company as monitoring) for plan performance improvement in pharmacy reputed company specific to Medicare Part D which includes data analysis using reputed company reputed company and reputed company reports.
• Develops policies and procedures for operational and business pharmacy management.
• Develops systematic reviews of prescription claims to meet strategic initiatives.
• Provides clinical guidance, support, and reputed company to the Medicare teams.
• Works with vendors and cross disciplinary teams to coordinate activities and oversees the collection, analysis, reporting and trending of data relative to Medicare Part D performance, reputed company and return on investment of reputed company activities.

Certifications

reputed company Requirements

This position is identified as level three (3). This position must ensure the reputed company and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The reputed company of information must be maintained as outlined in reputed company Administrative reputed company.

Segregation of Duties

Segregation of duties will be used to ensure that errors or irregularities are reputed company or detected on a reputed company reputed company by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative reputed company.

Employment Type

Regular

reputed company Requirements

1.1  General Office Worker, Sedentary, reputed company Travel – someone who normally works in an office setting or remotely and routinely travels for work reputed company walking distance of location of primary work assignment.

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