Manager, Healthcare Performance Improvement

2 weeks ago

Nashville, TN, United States Forvis Mazars Full time
Description & Requirements

What You Will Do:

  • Assist with developing pharmacy strategies, business plans, and pharmacy processes
    • Specialty pharmacy strategy
    • Ambulatory pharmacy
    • Inpatient pharmacy
    • Infusion services
    • Formulary management/pharmacy and therapeutic committee
    • Set up entity-owned pharmacies
    • Evaluate onsite pharmacies at entities
    • Evaluate entity formularies for opportunities
    • Assess pharmacy spending and quality outcomes
    • Pharmacy benefit manager
    • Payer contracting for pharmacy
    • Pharmacy billing and pricing
    • Pharmacy supply chain
  • Lead consulting engagements focused on specialty pharmacy compliance strategy, accreditation readiness, PBM access/credentialing, and regulatory adherence
  • Oversee the development and delivery of client-specific policies, procedures, workflows, training, and continuous quality improvement
  • Direct internal readiness assessments and mock audits for clients, identify compliance risks, and oversee mitigation plans with measurable outcomes.
  • Support business development initiatives, including proposal development, scope design, and client presentations.
  • Provide guidance to clients regarding their 340B and other pharmacy operations:
    • Operational Assistance
      • Split-billing vendor implementations
      • Split-billing vendor maintenance i.e., Drug Crosswalk Maintenance
    • Compliance Reviews
      • Independent Reviews
      • HRSA Audit Experience a plus
  • Policy and Procedure Development
  • 340B network expansion i.e., development of contract pharmacy arrangements, child sites, direct purchases, orphan drugs, and other opportunities
  • 340B Financial Reporting
  • Advise, communicate and present to all levels including C-suite, management, and pharmacy staff
  • Provide in-depth process knowledge and leadership to clients
  • Provide an unmatched client experience and identify additional value-added services
  • Active participant in specific healthcare industry groups (ASHP, Becker's, Apexus, 340B Health, HFMA, etc.)
Minimum Qualifications:
  • Bachelor's degree in business, pharmacy, technology, health services administration, or a related field
  • 5+ Years of prior healthcare consulting, pharmaceutical industry, or hospital environment experience
  • Significant expertise in advanced Excel, IT platforms, and healthcare
  • Strong technical skills, experience with spreadsheets, databases, and an automated audit work paper system
Preferred Qualifications:
  • Past experience with large/medium-sized consulting firm(s)
  • Pharm D. or bachelor's degree in pharmacy
  • Data visualization (Tableau or Power BI)
  • AI experience

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