Welcome page Returning Candidate? Log back in! Director Specialty Pharmacy Payer Strategy Job Locations US-MN-Minneapolis Requisition ID 2024-133676 Requisition Post Information* : Posted Date 3 hours ago(12/19/2024 1:08 PM) Requisition Post Information* : Posted Date Leadership/Management/Executive Community Hidden (26538) Shift day Hours per 2 weeks 80 Department Specialty Marketing Overview

Lead the strategy, planning, and execution of cutting-edge payer programs and services that position Fairview Specialty Pharmacy as a market leader in the competitive specialty marketplace. Drive the development of innovative initiatives that enhance our value proposition, ensure payer access, and boost profitability. Oversee business analytics supporting payer strategies that elevate revenue and enhance the patient and client experience. Additionally, provide consultative expertise to internal teams and external partners, including payers (health plans), employers, and health system clients, fostering collaboration and driving transformative solutions.

 

The pay range for this role is $171,000-$241,758 annual base and is dependent on candidate's amount and type of experience.  This role is also eligible to participate in a Managment Incentive program.

Responsibilities/Job Description

Strategy and Execution (35%):

Involved in the development, implementation, and management of a comprehensive, market-based payer strategy.Direct innovative programs, products, and services developed based on market need assessments, to increase Fairview Specialty’s value and ability to successfully compete and win in the market.Involved in the planning and successful execution of market-leading payer programs, products, and service offerings to position Fairview Specialty for success in competitive bidding scenarios against national specialty pharmacy organizations. Partner with senior leaders to evaluate and recommend specialty pharmacy strategies to M Health service lines to increase revenue and improve market position, while protecting margin. Ensure alignment of payer programs with Fairview’s strategic business initiatives.

Analytics and Consultative Services (25%)

Directs and manages reporting and analytic capabilities for the payer team which supports strategic decision-making and clear differentiation in the market.  Provides consultative expertise to assist clients with strategy formation, data interpretation, and recommendations for program and/or plan improvements. Directs efforts to develop, craft, and promote Fairview Specialty’s “value proposition” to payers, using data and analytics, to ensure specialty pharmacy access.Directs and manages enhancements to the Fairview Specialty reporting package to continue to meet and exceed client needs and strengthen market position. Collaborates with senior clinical, business, and technical leaders across the M Health organization to provide internal consultative services based on experience and expertise related to Total Cost of Care (TCOC) and population health modeling, use and understanding of acuity risk methodology and algorithms, data analytics, and health outcomes research.

Account Management & Sales (20%)

Account and relationship management of current and new specialty pharmacy payer accounts, resulting in client retention, loyalty, and profitability for the organization. Co-leads client meetings to review Fairview Specialty Pharmacy’s programs and performance results using comprehensive reporting tailored to client needs. Directs the development and execution of an annual plan outlining timely and market-relevant content for quarterly business review. Direct involvement in the review and analysis of contract proposals, performance guarantees, renewals, and other payer-related activities.Direct involvement in the creation of Fairview Specialty Pharmacy’s responses to “Requests for Proposals” (RFP/s) and/or “Requests for Information” (RFI/s) focused on obtaining additional payer or employer clients, members and/or partners.

Product Development (20%)

Leads analytics-based product delivery from inception to implementation. Creates and successfully implements innovative products and services:to manage costs, improve outcomes, and improve member satisfaction while differentiating Fairview Specialty as a market leader.for use within M Health Fairview to help differentiate M Health Fairview as a market leader related to overall Specialty management.

 The ideal candidate will have a passion for crafting and selling a vision for the specialty analytics product, collecting requirements from customers, and working with teams to serve both internal and external stakeholders at a best-in-class level.

Qualifications

Required

Education

MBA/MHA or PharmD degree and/or equivalent in specific applicable work experience.  *Equivalent experience equals an additional 3 years instead of a Master’s or PharmD degree

Experience

15+ years relevant work experience in strategy development and account management, in the PBM, specialty pharmacy, and/or managed care industry.15+ years of relevant work experience performing analytics in the PBM, specialty pharmacy, and/or managed care industry.10+ years of leadership/people management experienceIn-depth knowledge of payer/PBM economics and a strong understanding of key issues and market levers, given the changing US healthcare landscape.Ability to apply analytical insight to drive account performance and ability to “ask the right questions” of analytical resources.Experience with health outcomes and clinical analytics including utilization, access to care, quality outcomes, quality process and care gaps identification.Strong data interpretation/presentation and data visualization skills Experience must include working with health care transactional data (claims) and other health-related data sets as well as knowledge of federal and state laws pertaining to healthcare information privacy and security. Options Apply for this job onlineApplyShareEmail this job to a friendRefer Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Share on your newsfeed Need help finding the right job? We can recommend jobs specifically for you! Click here to get started.

As part of Fairview Health Services, Ebenezer is driven to heal, discover and educate for longer, healthier and meaningful lives for seniors. Ebenezer’s almost 4,000 employees work as a team to provide the highest quality care to those we serve. Our employees don’t work simply to collect a paycheck; they truly work to make a difference in the lives of older adults in their communities. A culture of caring for others is grounded in our values of Dignity, Integrity, Service, Compassion and Innovation.

We are located in Minnesota, Florida, Iowa, Nebraska and Wisconsin hosting a variety of community settings such as; Independent Living, Assisted Living, Memory, Transitional and Long term Care. Additionally we offer Adult and Intergenerational Day programs, Community-based services, Management and Consulting Services and The Ebenezer Foundation. Because of our size, variety of community settings, and our partnership with Fairview Health Services https://www.fairview.org we can offer opportunities for career growth and reinvention.

If you share our commitment to quality care for older adults, there’s a place for you at Ebenezer!

EEO/AA Employer/Vet/Disabled All qualified applicants will receive consideration without regard to any lawfully protected status. Application FAQs

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