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Title: Director of Government Programs, Consulting and Delivery

The Director of Government Programs, Consulting and Delivery is responsible for driving the Medicare and Medicaid strategy and delivery of Pharmacy Benefit Management practices

This leader role will establish direction-setting/guidance for clients and PSG team members with a focus on national and regional health plans. Lead and cultivate multi-level client relationships with senior executives, pharmacy department leadership and personnel, sales and product leads, clinical management and others which enable PSG to partner with clients to create, communicate and implement pharmacy strategy within the context of the overall healthcare strategy. Identify business needs and create custom solutions for sophisticated clients which include overall pharmacy benefit and medical management initiatives to address the overall goal of healthcare affordability.  Lead vendor (PBM) strategies that will include procurement efforts, contract negotiation and ongoing vendor management. Oversee and educate client and PSG personnel on Medicare and Medicaid compliance, delivery timelines, and operational requirements. Provide industry expertise and insight related to cost and trend management opportunities.

Implementation and Delivery

  • Guide and oversee Medicare and Medicaid delivery across implementation projects.
  • Act as a subject matter expert on relevant topics, regulations, and trends.
  • Develop integration and process standards and best practices for Medicare and Medicaid operations and innovation.
  • Responsible for identifying, evaluating, and recommending operational and tactical improvements required to support and improve the business processes within PSG and as part of the consulting services to clients.
  • Create and execute an implementation support strategy that drives industry best practice, standardization, efficiency, flexibility, and innovation
  • Understand existing PBM capabilities and assess new capabilities necessary to achieve market compliance.
  • Partner with clients to develop and implement customized strategic plans based on unique client needs to achieve targeted long- and short-term goals.
  • As appropriate, serve as part of the client-facing government program leader for pharmacy projects. This includes consulting and tactical delivery required for PBM migrations.
  • Identify issues and concerns for appropriate escalation and resolution to ensure successful transition.
  • Lead or partner with PSG colleagues to assess vendor products or new technologies.
  • Ability to manage a complex mix of implementation projects while optimizing resource allocation based on strategy and business goals
  • Manage vendors and consultants and provide day-to-day oversight of junior team members.
  • Coach, train, and challenge team members to develop their skills and expertise; conduct performance evaluations.

Program and Business Development

  • Assess opportunity for expanding PSG services within existing client relationship.
  • Leverage client relationship for PSG prospecting efforts by creating developing client reference.
  • Participation in conferences and other forums for showcasing program experience and success.
  • Participate in internal workgroups to develop new programs, services, corporate positions and   publications based on the continual assessment of client and market needs.

RFP Process Management

  • Participate in non-client RFP process via scoring and client meeting assistance.

Experience, Education and Specialized Knowledge and Skills

Must thrive working in a fast-paced, innovative environment while remaining flexible, proactive, resourceful, and efficient. Must have excellent interpersonal skills, the ability to develop important relationships with clients and key stakeholders, good conflict management and negotiation skills, and the ability to analyze complex issues to develop relevant and realistic plans, programs, and recommendations. Must have a demonstrated ability to translate strategy into action, excellent analytical skills, and an ability to communicate complex issues in a simple way and to orchestrate plans to resolve issues and mitigate risks.

Qualifications

  • Extensive knowledge of PBM, specialty pharmacy or managed care environments (5-7 years minimum experience).
  • Strong verbal and written communication skills including presentation skills and client relationship management experience.
  • Ability to develop strategies and implement programs for large client Rx and medical benefit programs
  • Strong clinical and financial analysis skills including: Word, PowerPoint and Excel
  • Pharmacy background with bachelor’s degree; MBA or PharmD/RPh strongly preferred
  • Business development experience preferred

Salary and Benefits

  • Salary is based on background and experience but average roles in this range pay between $150,000-175,000 and we anticipate hiring within that range. Benefits include full medical, pharmacy, dental, vision, life and disability insurance, paid vacation, sick leave, 401k match and annual bonus potential. 

 

 

WHY JOIN US? 

  • 15th Largest Broker in US
  • Voted " Best Place to Work" in the Insurance Industry
  • Awesome Benefits:  401K matching, Generous Time Off Policy, Flexible Work Options, Medical, Dental, Vision, Pet Insurance, Cancer Insurance, Wellness Programs, Employee Award Programs (Trips!).

EPIC embraces diversity in all its various forms—whether it be diversity of thought, background, race, religion, gender, skills or experience. We are committed to fostering a work community where every colleague feels welcomed, valued, respected and heard. It is our belief that diversity drives innovation and that creating an environment where every employee feels included and empowered, helps us to deliver the best outcome to our clients. 

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