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Senior Director, Pharmacy Benefits FRx

Company: Fresenius Kidney Care
Location: Franklin
Posted on: March 20, 2023

Job Description:

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 patient
  • 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 strategies.
  • 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 requirements.
  • 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 pharmacy.
          • 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 productive teams.
          • 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 Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws. EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender 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 to send you new job opportunities!

Keywords: Fresenius Kidney Care, Franklin , Senior Director, Pharmacy Benefits FRx, Healthcare , Franklin, Tennessee

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