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Job Summary

This position leads all Medical Drug efforts within Enterprise Pharmacy. It sets strategic direction for Medical Drug reimbursement, oversees development of Medical Drug fee schedules (across Professional and Facilities), establishes governance and processes to implement those fee schedules, and works cross-functionally with stakeholders across the organization to drive value creation on an array of Medical Drug initiatives. This position has a deep understanding of health plan reimbursement and of the overall pharmacy value chain. It is skilled at data analysis, and at utilizing data to inform decision-making. It attracts, retains, and develops a strong team.

Job Responsibilities:
• Set strategic direction for Enterprise Pharmacy Medical Drug efforts. Analyze data to identify and prioritize most impactful initiatives across reimbursement, medical drug rebates, etc.
• Conducts financial analysis and provides strategic insights and recommendations to guide Pharmacy and market leadership decision making.
• Oversee development of standard and custom Medical Drug fee schedules, for both Professional providers and Facilities. Incorporate external benchmarking, internal data, and stakeholder feedback into schedule development.
• Develop and implement additional Medical Drug initiatives (e.g. preferred drug strategies, site of care, rebate strategies).
• Set up governance structure and process for implementing Medical Drug initiatives, and lead collaboration with cross-functional stakeholders – including in Healthcare Mgmt. and Network Business Solutions – to drive implementation of Medical Drug initiatives.
• Develop materials that explain Medical Drug initiatives to internal and external audiences.
• Synthesize and analyze industry and competitor trends for the enterprise, to build competitive advantage by ensuring market movement is reflected in internal decision making.
• Help define output for Analytics team that surfaces insights on Medical Drug spend and tracks financial and stakeholder impact from Medical Drug initiatives, pushing to output that informs decision-making.
• Oversee the monitoring and reporting of performance across Medical Drug – including financial, operational, and sales performance metrics.
• Provide strategic leadership and direction to high performing team. Develop talent across the organization, ensuring a diverse talent pipeline.

Required Job Qualifications:
• 5 or more years of experience in healthcare plus 3 or more years of experience in a senior leadership position
• Deep understanding of the pharmacy value chain
• Analytical strategic thinker, with the financial and business acumen to analyze data and translate into actionable takeaways
• Highly articulate communicator and compelling leader able to develop a clear vision and translate it into goals and results.
• Demonstrated ability to manage complex programs and processes in a manner that drives to tangible impact
• Ability to manage multiple complex priorities. Flexible, resourceful, able to work in an ambiguous environment.

Preferred Job Qualifications:
• MBA or other advanced degree
• Experience with health plan or pharmacy reimbursement (e.g., health plan network/contracting or pharmacy contracting)

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees.  Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range

$130,800.00 - $242,800.00

Exact compensation may vary based on skills, experience, and location.