Senior Director, Pharmacy Benefits FRx
Company: Fresenius Kidney Care
Posted on: March 20, 2023
Senior Director, Pharmacy Benefits FRx page is loaded Senior
Director, Pharmacy Benefits FRx Apply locations Franklin, TN, USA
time type Full time posted on Posted 2 Days Ago job requisition id
R0077572 PURPOSE AND SCOPE: Sr. Director Pharmacy Benefits, FRx
will lead teams that act the liaison between patients, clinics,
prescribers, operations, payor relations and third-party payers to
resolve issues related to medication benefits and/or claims. Will
develop strategy for complex benefit plans and create, organize,
and direct staff of pharmacy benefit claims. This position will
review and audit medication benefits and claims to ensure
appropriate information is obtained and that action is taken
appropriately. PRINCIPAL DUTIES AND RESPONSIBILITIES:
- Provide strategic leadership of short- and long-term goals
through the use of thoughtful techniques in the communication of
the company's mission and core values as a means to implement
positive change and/or create organizational structure within the
assigned business unit(s).
- Ensures complex services and strategic projects are correctly
assessed and expansions occur in a quality, sustainable manner.
Institutes processes and assists in the development of system
designs to provide pharmacy benefits at the highest level.
- Directs, creates, and controls processes to identify
prescription insurance coverage options available for a
- Establishes processes to support coordination of benefits
including Medicare Extra Help, manufacturer-sponsored programs, and
other cost-saving programs for patients to provide best options for
patients to obtain medications during coverage gap
- Designs, implements, and maintains processes to support
streamlined workflows to ensure that accurate insurance coverage
information is applied to pharmacy claims
- Investigates manufacturer programs and discount cards available
for renal patients
- Develops continued training to help educate about Medicare,
Medicaid, LIS, dual eligibility, and Commercial plans
- Provides insight and analysis on patient out of pocket cost
impacts based on changes in prescription benefit plans, pharmacy
supplier costs, and available patient support programs
- Leads the broad activities of the business unit(s) through the
interpretation, application and implementation of company-wide
policies and processes appropriate to the functional area(s).
- Strategic leader with broad-based knowledge in individual
departments, and strong knowledge of industry practice and business
principles. Works on complex issues where analysis of situations or
data requires an in-depth knowledge of the company.
- Participates with other senior managers to establish strategic
plans and objectives. Develops strategies for direct departments,
and contributes to the development of divisional/business unit
- Makes final decision on administrative or operational matters,
and ensures operations effective achievement of objectives.
- Interprets and provides recommendations for change of
company-wide policies and practices. Establishes policies
appropriate for the function.
- Responsible for managing a functional area on a national level,
or multiple functional areas within a company division. Directs and
controls the activities of a broad functional area through several
lower department managers within the company.
- Significant organizational impact responsible for the overall
control of planning, staffing, budgeting, expense priority
management, and recommending and implementing changes to current
methods. Ensures that budgets and schedules meet corporate
- Broad latitude for decisions within scope of the job. Decisions
are usually complex and have an impact on the business beyond the
functional area with serious impact on the overall success or
failure in the area of accountability. - Erroneous decisions will
have a serious impact on the overall success of functional,
division or company operations.
- Regularly interacts with executives, senior management, and/or
major customers. Interactions frequently require special skills
such as negotiating or influencing customers and/or senior level
leaders in matters of significance to the organization.
- Interacts with all levels within the organization to manage
functional area. Overall responsibility for hiring, coaching and
counseling employees, including performance reviews, disciplinary
action and terminations.
- Provides technical guidance.
- Assists with various projects as assigned.
- Other duties as assigned. Additional responsibilities may
include focus on one or more departments or locations. See
applicable addendum for department or location specific functions.
PHYSICAL DEMANDS AND WORKING CONDITIONS:
- The physical demands and work environment characteristics
described here are representative of those an employee encounters
while performing the essential functions of this job. Reasonable
accommodations may be made to enable individuals with disabilities
to perform the essential functions.
- Travel up to 10% SUPERVISION:
- May be responsible for the direct supervision of various levels
of managerial and predominately exempt staff. EDUCATION :
- Bachelor's Degree required; Advanced Degree preferred
EXPERIENCE AND REQUIRED SKILLS:
- 10+ years' related experience in finance, insurance, and
- 5+ years' experience as a Manager; or 5+ years' experience in a
senior managerial role.
- PBM Experience
- Experience with Medicare
- Background in pharmacy benefits investigation and benefit
design and analysis
- Understand of pharmacy and social work
- Strong management skills with the ability to lead cohesive and
- Strong interpersonal skills with the ability to communicate
with all levels of management through diplomacy and tact.
- Excellent oral and written communication skills. EO/AA
Orientation/Gender Identity Fresenius Medical Care North America
maintains a drug-free workplace in accordance with applicable
federal and state laws. EO/AA Employer:
Identity Fresenius Medical Care North America maintains a drug-free
workplace in accordance with applicable federal and state laws.
About Us Our Work Experience is the combination of everything
that's unique about us: our culture, our core values, our company
meetings, our commitment to sustainability, our recognition
programs, but most importantly, it's our people. Our employees are
self-disciplined, hard working, curious, trustworthy, humble, and
truthful. They make choices according to what is best for the team,
they live for opportunities to collaborate and make a difference,
and they make us the #1 Top Workplace in the area. Join our Talent
Network! Let's stay connected! Joining our talent network allows us
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Keywords: Fresenius Kidney Care, Franklin , Senior Director, Pharmacy Benefits FRx, Healthcare , Franklin, Tennessee
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