Description
Director of Specialty Pharmacy Payor Services
CPS Solutions
Remote/Home-based
CPS Solutions is looking for a Director of Specialty Pharmacy Payor Services to join our specialty pharmacy team. This position leads the development and successful implementation of pharmacy services to ensure a client's payor contracting, benefits design and services and revenue cycle management for pharmacy services, build strong collaborative relationships with other key leaders and professionals within CPS, client leaders and other key stakeholders in the organization.
Salary Range: $150K to $170K - based on experience, plus bonus
Schedule: This position works at least 40 hours per week, primarily Monday - Friday and requires travel away from a home location for varying lengths of time up to 60%.
RESPONSIBILITIES:
-Facilitate and assist in the development of client-specific specialty and ambulatory pharmacy payor implementation plans. This includes:
-project management
-assisting in financial assessments
-review of benefits and services
-pharmacy and ERx data review
-revenue cycle management review and value
-managing requests and purchases
-Assist in the development and successful execution of integrated strategies for the delivery of payor strategies and other key initiatives to achieve high quality affordable care and improve the health of those served
-Facilitating payor credentialing, claims reconciliation and request for proposal for clients
-Support a high-level of collaboration between client's pharmacy, medical contracting and benefits teams, and executive leadership to leverage organizational, pharmaceutical and medical expertise to develop and maximize payor programs, strategy and access
-Execute upon goals, strategies and tactics to ensure ongoing client success, this includes; helping clients grow their pharmacy programs and ensuring that their program achieves profitable growth
-Identify opportunities and issues that impact client services and performance by engaging key stakeholders to plan, develop, and successfully execute timely and appropriate initiatives and solutions that result in appropriate performance improvement
-Establish systems to manage external relationships with third-party payors on behalf of CPS clients, including overseeing compliance and credentialing of programs and specialty pharmacy network contract
QUALIFICATIONS:
-Bachelor's degree in a health care related field
-Five (5) years of successful, progressive leadership experience
-Experience managing pharmacy payors contracting and implementing benefits design desired
-Demonstrated experience collaborating with diverse stakeholders enhancing business results through high quality and cost-effective specialty pharmacy services, executing complex projects preferably in a hospital setting
-Building effective relationships with key stake holders, and optimization strategies is preferred
-Able to travel approximately 60% of the time away from home location
-Ability to travel by air or car
-Ability to meet company standards for a Motor Vehicle Report (MVR) background check
Benefits: All employees enjoy a competitive salary, eligibility to participate in the 401(k) savings plan with a match. Full Time employees are also eligible for a comprehensive benefits package, including Medical, Dental and Vision Insurance, Time Off Plan, Company Paid Short- and Long-Term Disability, Basic and Supplemental Life Insurance, Medical Flex and Dependent Care Accounts and more.
CPS Solutions, LLC Requirements: All employment offers are contingent upon successfully passing a pre-employment (post offer) background check, drug test and signed onboarding documents. Additionally, you may be required to provide medical records or have additional medical examinations/background checks that are a specific requirement of the location or position in which you are hired. Due to the healthcare requirements of the location where you will work and the clients we support, this may include a COVID vaccine. This applies to internal transfers and status changes for internal CPS Solutions, LLC team members. CPS Solutions, LLC is also committed to a safe and drug free workplace. The use of marijuana for medical purposes accompanied by a prescription, even if permitted by state law, will not be considered acceptable for purposes of explaining a positive lab test result for marijuana.
About CPS Solutions, LLC: Founded nearly 50 years ago and employing over 2,500 clinical, regulatory, and operational pharmacy professionals, CPS Solutions, LLC, is one of the nation's largest providers of pharmacy services to more than 800 hospitals and healthcare facilities nationwide. CPS Solutions, LLC helps clients tackle a variety of complex issues, such as operational efficiency, rising drug costs, regulatory & compliance, 340B, and specialty pharmacy strategy. CPS Solutions, LLC helps healthcare leaders drive best in class pharmacy operations through skill, expertise, and proprietary technologies. For more information, visit https://www.CPS.com.
We are an Equal Opportunity Employer and do not discriminate against any qualified employee or applicant for employment because of race, color, sex, age, national origin, ancestry, religious creed, sexual orientation, gender identity and/or expression, status as a veteran, mental or physical disability or any other federal, state or local protected class.
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