Pharmacy Financial Lead

3 days ago

Farmington, New Mexico, United States Medical Card System, Inc. Full time

Pharmacy Financial Lead
Regular

Exempt

GENERAL DESCRIPTION
Responsible for the Pharmacy Department Financial Activities such as Budget and Savings Initiatives. Develops, analyzes, and evaluates pharmacy savings initiatives and monitors the quarterly savings of these. Ensure accurate budget development and performance oversight. Translates needs and requirements of the operational and clinical area into reports modeling and integrating data from various sources. These responsibilities are tied to MCS and Global Health Financial Activities.

ESSENTIAL FUNCTIONS

  • Lead and support EMMs initiatives activities in accordance with established schedules, milestones, resources, issues, and scope. Ensure that all projects are well scoped, well documented, and completed on time. Also, regularly informs executive sponsors and key stakeholders of the project's status.
  • Will meet directly with providers and/or participate in committees or work sessions to collect the requirements and needs of the EMM initiatives, this with the purpose of serving as a technical expert at the pharmacy area to develop and agree on the final report solution. that supports effective EMM's Initiatives savings calculation.
  • Collaborate with key stakeholders to identify projects gaps, barriers, and opportunities for improvement.
  • Develop and implement issues resolution and enhancements that are align with the pharmacy department financial objectives.
Resolve issues before health plan performance results are impacted.

  • Participates in high-impact corporate projects for the company in which it must collect requirements, define, and create the solution that facilitates the monitoring of performance metrics. This solution should facilitate the performance of the necessary analyses to be presented to the clinical or operational area.
  • Understand and perform savings projections analysis and monitoring.
  • Document for each EMM Initiative a sum the summary of the savings projections calculation logic and supporting report.
  • Works with Finance, Actuarial, and other related departments in the preparation of the departmental budget. Assists finance by providing analysis of drug utilization and cost trends. It is the link between the PBM and Finance in the request of the reports used so that the Budget can be calculated.
  • Identifies patterns and/or trends of financial impact related to drug costs and presents them in a monthly meeting with pharmacists so that they can identify which drugs can affect the positive or negative variances of the budget.
  • Interprets and analyzes utilization reports that reflect financial impact trends, to support senior management in decision making; makes recommendations in this regard.
  • Ensures that a gap analysis to identify drivers for budget variances is performed and perform analysis that supports the driver's identification. Develop with the clinical area initiatives to close variances and monitor effectiveness of the initiatives.
  • Perform PBM Financial Guarantees oversight. Ensures that a gap analysis to identify drivers for identified variances is performed. Perform analysis that supports the driver's identification. Develop with the PBM initiatives to close variances and monitor effectiveness of the initiatives.
  • Perform MAC Pricing Process Oversight. Ensures that a gap analysis to identify drivers for identified variances is performed. Perform analysis that supports the driver's identification. Develop with the PBM initiatives to close variances and monitor effectiveness of the initiatives.
  • Conduct thorough review and validation of invoices received from vendors and ensure accuracy and adherence to contractual agreements and pricing structures. Identify and resolve any discrepancies or billing errors in a timely manner, collaborating with relevant stakeholders to rectify issues and prevent future occurrences.
  • Develops and/or creates reports integrating several databases. Analyze, identify, and present patterns and/or trends of financial impact to make projections that serve senior management in decision making.
  • Collaborate with key stakeholders to identify gaps, barriers, and opportunities for improvement, also develop and implement enhancements that are align with the pharmacy's programs objectives.
  • Identify and reports significant issues and underlying problems, accompanied by proposed solutions, in a timely manner to leadership. Also, resolving issues before health plan performance results are impacted.
  • Prepare and deliver presentation materials for management level, internal or external users.
  • Perform Financial Analysis, tracking and trends.
  • Collaborates with cross-functional teams to ensure compliance and quality requirements are met as per local and federal laws and regulations and other agencies.
  • Participates and collaborates with internal and external audits, in the division's processes automation, corporate and departmental initiatives, and other similar tasks.
  • Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices.
  • May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.

MINIMUM QUALIFICATIONS

Education and experience: Bachelor's Degree in Business Administration, Finance, Pharmacy, Statistics, Biostatistics, Quantitative Methods, or related areas. At least five (5) years of previous experience performing similar responsibilities analyzing, managing data, and making presentations in the Healthcare industry.

"Proven experience may be replaced by previously established requirements."

Certifications / Licenses: N/A

Other: Intermediate or Advanced knowledge of Excel.

Knowledge of the following databases:
Tableau, ACCESS, Power Pivot, and Power BI. Knowledge in analyzing and managing tables and relationships in databases. Knowledge of Medicare Star Program requirements is preferred.

Languages:

Spanish - Advanced (writing, conversational, comprehension, and reading)

English - Advanced (writing, conversational, comprehension, and reading)

"Somos un patrono con igualdad de oportunidad en el empleo y tomamos Acción Afirmativa para reclutar a Mujeres, Minorías, Veteranos Protegidos y Personas con Impedimento"

  • Pharmacy Financial Lead

    2 months ago

    Farmington, New Mexico, United States Medical Card System, Inc. Full time

    Pharmacy Financial LeadRegularExemptGENERAL DESCRIPTIONResponsible for the Pharmacy Department Financial Activities such as Budget and Savings Initiatives. Develops, analyzes, and evaluates pharmacy savings initiatives and monitors the quarterly savings of these. Ensure accurate budget development and performance oversight. Translates needs and requirements...

  • Pharmacy Financial Lead

    4 weeks ago

    Farmington, New Mexico, United States Medical Card System, Inc. Full time

    Pharmacy Financial LeadRegularExemptGENERAL DESCRIPTIONResponsible for the Pharmacy Department Financial Activities such as Budget and Savings Initiatives. Develops, analyzes, and evaluates pharmacy savings initiatives and monitors the quarterly savings of these. Ensure accurate budget development and performance oversight. Translates needs and requirements...

  • Clinical Strategy and Practice Lead Pharmacy Home Infusion Network

    2 months ago

    Farmington, New Mexico, United States CenterWell Full time

    *Become a part of our caring community and help us put health first*The Clinical Strategy and Practice Lead builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise. The Clinical Strategy and Practice Lead works on problems of diverse scope and complexity ranging from moderate to...

  • Clinical Strategy and Practice Lead Pharmacy Home Infusion Network

    4 weeks ago

    Farmington, New Mexico, United States CenterWell Full time

    *Become a part of our caring community and help us put health first*The Clinical Strategy and Practice Lead builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise. The Clinical Strategy and Practice Lead works on problems of diverse scope and complexity ranging from moderate to...

  • Actuarial Lead

    4 weeks ago

    Farmington, New Mexico, United States Medical Card System, Inc. Full time

    Actuarial LeadRegularExemptGENERAL DESCRIPTIONResponsible for analyzing pricing, financial reporting and reserves, and product development for all companies' products. Accountable for assessing the financial risks associated with products, and related services. Provide guidance and analytical support to optimize pricing, manage risk, and ensure the financial...

  • Actuarial Lead

    3 months ago

    Farmington, New Mexico, United States Medical Card System, Inc. Full time

    Actuarial LeadRegularExemptGENERAL DESCRIPTIONResponsible for analyzing pricing, financial reporting and reserves, and product development for all companies' products. Accountable for assessing the financial risks associated with products, and related services. Provide guidance and analytical support to optimize pricing, manage risk, and ensure the financial...

  • Financial Controller m/f/d

    2 months ago

    Farmington, New Mexico, United States Eurofins Full time

    Eurofins Scientific through its subsidiaries is the world leader in food, environment, pharmaceutical and cosmetic product testing, discovery pharmacology, forensics, advanced material sciences, and in agroscience Contract Research services.With over 61,000 staff across a network of more than 1,000 independent companies in 59 countries and operating 940...

  • Pharmacist - Day Shift - Specialty Exp / Oncology Cert Preferred

    4 weeks ago

    Farmington, New Mexico, United States Kroger Full time

    Perform functions to dispense prescription medications to patients in keeping with providers prescription orders, provide expert counsel to patients regarding the safe use of prescription medications, and ensure that pharmacy prescription services are provided in compliance with regulatory, policy and procedure requirements for accuracy, safety, and...

  • Pharmacist - Day Shift - Specialty Exp / Oncology Cert Preferred

    2 months ago

    Farmington, New Mexico, United States Kroger Full time

    Perform functions to dispense prescription medications to patients in keeping with providers prescription orders, provide expert counsel to patients regarding the safe use of prescription medications, and ensure that pharmacy prescription services are provided in compliance with regulatory, policy and procedure requirements for accuracy, safety, and...

  • Pool Attendant

    4 weeks ago

    Farmington, New Mexico, United States Sonesta International Hotels Corporation Full time

    SummaryThe Pool Attendant is responsible for our beach and pool operation, retail area, and assisting guest and locals with questions regarding the resort. Excellent verbal communication and customer skills, able to perform physical labor in harsh weather conditions. Ability to move and lift heavy furniture and equipment, as well as handing out towels,...

  • Pool Attendant

    2 months ago

    Farmington, New Mexico, United States Sonesta International Hotels Corporation Full time

    SummaryThe Pool Attendant is responsible for our beach and pool operation, retail area, and assisting guest and locals with questions regarding the resort. Excellent verbal communication and customer skills, able to perform physical labor in harsh weather conditions. Ability to move and lift heavy furniture and equipment, as well as handing out towels,...

  • Housekeeping Receptionist

    1 month ago

    Farmington, New Mexico, United States Sonesta International Hotels Corporation Full time

    SummaryThe Housekeeping Coordinator is an important role to the hotel success. This role that requires great organization skills and flexibility to work with hotel management for overall success. Will be required to work mornings, evening, weekends, and holidays. Track and maintain the square footage of all Room Attendants•Assist with scheduling and room...

  • Housekeeping Receptionist

    4 weeks ago

    Farmington, New Mexico, United States Sonesta International Hotels Corporation Full time

    SummaryThe Housekeeping Coordinator is an important role to the hotel success. This role that requires great organization skills and flexibility to work with hotel management for overall success. Will be required to work mornings, evening, weekends, and holidays. Track and maintain the square footage of all Room Attendants•Assist with scheduling and room...

  • Associate Director Performance Suite Analytics

    15 hours ago

    Farmington, New Mexico, United States Evolent Health Full time

    *Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved...

  • Bartender

    2 months ago

    Farmington, New Mexico, United States Sonesta International Hotels Corporation Full time

    SummaryThe Bartender is responsible for consistently delivering results that contribute to the mission and overall success of the hotel by accomplishing performance objectives covering the social venues of the hotel. The bartender sets-up, services, and breaks-down the bar area ensuring a high level of quality, consistency and service. Welcoming customers,...

  • Bartender

    4 weeks ago

    Farmington, New Mexico, United States Sonesta International Hotels Corporation Full time

    SummaryThe Bartender is responsible for consistently delivering results that contribute to the mission and overall success of the hotel by accomplishing performance objectives covering the social venues of the hotel. The bartender sets-up, services, and breaks-down the bar area ensuring a high level of quality, consistency and service. Welcoming customers,...

  • IT Manager

    1 month ago

    Farmington, New Mexico, United States Creative Financial Staffing Full time

    Our client is seeking a highly motivated and experienced IT Manager to join our team. The ideal candidate will be responsible for the overall management of our IT infrastructure, including network set up, LAN/WAN, IT security, troubleshooting IT issues, and setting up workstations.Responsibilities:Manage and maintain the company's IT infrastructure,...

  • IT Manager

    4 weeks ago

    Farmington, New Mexico, United States Creative Financial Staffing Full time

    Our client is seeking a highly motivated and experienced IT Manager to join our team. The ideal candidate will be responsible for the overall management of our IT infrastructure, including network set up, LAN/WAN, IT security, troubleshooting IT issues, and setting up workstations.Responsibilities:Manage and maintain the company's IT infrastructure,...

  • Group Renewal Senior Underwriter

    4 days ago

    Farmington, New Mexico, United States Medical Card System, Inc. Full time

    Group Renewal Senior UnderwriterRegularExemptGENERAL DESCRIPTION:Responsible for analyzing, collecting, and interpreting utilization, product, and benefits information on the health coverage of the MCS Life Insurance In-House Account segment. This aims to calculate group health and life renewal rates to establish adequate premium volumes, thus establishing...

  • Security Officer-1

    1 month ago

    Farmington, New Mexico, United States Sonesta International Hotels Corporation Full time

    SummaryThe Security Officer is responsible for the safety and security of all our guests, employees and visitors of the hotel. They are responsible for protection of all hotel assets, ensuring that hotel security policies and procedures in accordance with Sonesta Hotels International corporate guidelines are enforced and that the hotel is in full compliance...