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Associate Dir, Pharmacy
4 months ago
Associate Director, Pharmacy
SummaCare - 1200 E Market St, Akron, OH
Full-Time / 40 Hours / Days
Hybrid
SummaCare is a Summa Health entity that offers health insurance in northern Ohio. As a regional, provider-owned health plan, SummaCare is based in Akron, Ohio, and provides Medicare Advantage, individual and family and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2024 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits.
Summary:
Leads the administrative functions of the pharmacy department; including but not limited to pharmacy programs, pharmacy vendors and manages cross-functional relationships across the organization. Principal responsibilities include contract management, project management, quality improvement, budgeting, maintaining compliance with all policies, procedures, accreditation requirements and regulations. Facilitates communication, coordination, and collaboration among disciplines and departments regarding identification, planning, and provision of high quality, cost-effective care.
Formal Education Required:
a. Pharm. D. or Bachelor degree in pharmacy from an accredited College or School of Pharmacy.
b. Must be a licensed pharmacist within the United States.
c. Pharm. D. or MBA in addition to pharmacy license preferred.
Experience & Training Required:
a. Three (3) years experience in pharmacy administration in a health plan or Pharmacy Benefit Manager (PBM) to include:
i. Two (2) years working knowledge of Medicare.
Essential Functions:
1. Plans, prepares, implements and monitors area's operational and capital budgets to ensure sound financial management consistent with the goals of SummaCare.
2. Contract management of pharmacy department vendors, including ability to understand, manage, monitor performance guarantees and ability to participate and drive RFP and market check processes.
3. Management of direct contracted Specialty Pharmacies, including contract management and oversight of daily operations.
4. Rebate management and oversight
5. Provides pharmacy bid support to Medicare and Marketplace during annual filings.
6. Project management of implementation of new programs, products, lines of business, and new federal or local requirements.
7. Assists Director of Pharmacy in managing pharmacy and drug spend budgets and identifying and tracking savings initiatives and opportunities.
8. Drives initiatives to support Medicare Part D 5 Star measures.
9. Administers, monitors, coordinates, implements, and reports on utilization information related to drug benefits for all lines of business.
Other Skills, Competencies and Qualifications:
a. Effective contract management
b. Effective project management
c. Read, analyze and interpret primary medical literature, government regulations, CMS memos, general business periodicals, professional journals, technical procedures, standards and specifications.
d. Apply principles of logical thinking to define problems, collect data, establish facts, draw valid conclusions and prepare recommendations
e. Efficient in Microsoft Word, Excel, Outlook, and PowerPoint.
f. Effective interface with all staff levels
g. Ability to multi-task, organize and manage time to accurately complete tasks within designated time frames in a fast-paced environment.
h. Maintain current knowledge of and comply with regulatory and company policies and procedures.
i. Maintain confidentiality of member health and business information.
j. Ability to adjust work hours to meet business demands.
Level of Physical Demands:
a. Light: Exerts up to 20 pounds of force occasionally and/or up to ten pounds of force frequently, and/or a negligible amount of force continuously.
$59.64/hr - $89.46/hr
The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.
