[Remote] Manager Medicare Pharmacy Operations

Note: The job is a remote job and is open to candidates in USA. Arkansas Blue Cross and Blue Shield is seeking a Manager Medicare Pharmacy Operations who will serve as a liaison with contracted vendors providing administrative and clinical services for the pharmacy program. This role involves developing and implementing new benefit plans and strategies to enhance the company's competitive position while ensuring compliance with Medicare requirements.ResponsibilitiesCollaborates with team to prepare reporting and documentationConsults, recommends, and/or develops quality and cost initiatives to enhance the Centers for Medicare & Medicaid Services (CMS) measures of our Part D lines of businessDevelops, implements, and evaluates quality control opportunities (also known as monitoring) for plan performance improvement in pharmacy practice specific to Medicare Part D which includes data analysis using Microsoft Excel and Access reportsDevelops policies and procedures for operational and business pharmacy managementDevelops systematic reviews of prescription claims to meet strategic initiativesProvides clinical guidance, support, and oversight to the Medicare teamsWorks with vendors and cross disciplinary teams to coordinate activities and oversees the collection, analysis, reporting and trending of data relative to Medicare Part D performance, outcomes and return on investment of intervention activitiesSkillsBachelor's degree in a medical field requiredMinimum seven (7) years' experience within a pharmacy, clinical, and/or related health program administration function OR applicable Masters in related field with minimum five (5) years' experienceMinimum five (5) years' experience dealing with external vendors and end users. (Example: Contract negotiating/management, coordinating and assuring vendor compliance etc.)Minimum two (2) years' leadership experience (role, team and/or project management)Ability to travelAbility to work collaboratively and independently in a matrix work environmentAbility to understand individual and operational problems and identifying appropriate solution(s)Ability to perform under pressure and/or oppositionPharmacy Doctorate (PharmD) or Nurse Practitioner (NP) from an accredited college preferredExperience in managed care, pharmacy management, utilization management, or other related functions preferredKnowledge of the Medicare Part D and Medicare Advantage benefits preferredCompany OverviewArkansas Blue Cross and Blue Shield provides reliable insurance plans to Arkansans while being a valuable community partner. It was founded in 1948, and is headquartered in Little Rock, Arkansas, USA, with a workforce of 1001-5000 employees. Its website is http://www.arkansasbluecross.com.