Berkley Medical Management Solutions (BMMS) provides a different kind of managed-care service for W.R. Berkley Corporation. We believe focusing on an injured worker’s successful and speedy return to work is good for people and good for Berkley’s insurance operating units. BMMS was first started in 2014 by reimagining the relationship between medical need and technology as a way to deliver the best outcome for injured workers and Berkley’s operating units. Our goal was clear: combine solid clinical practices, proven return-to-work strategies and robust software into one system for seamless management of workers’ compensation cases.
To get it right, we started with a flexible technology platform that allowed for impressive customization without sacrificing the ability for expansion and continued innovation. We deploy integrated systems to give W.R. Berkley Companies recommendations and professional services for managing each individual case in an efficient and appropriate manner. The power of our technology takes medical bill-review services and clinical advisory services to a new level. Our unique marriage of technology, software platforms, data analytics and professional services ensures we provide Berkley’s operating units with reliable results, and reduced time and expenses associated with case management.
ResponsibilitiesAs the Manager, Pharmacy Services you will be the primary liaison for all components of the pharmacy program, collaborating with our pharmacy benefit manager, our product management team and our clients. You will provide guidance, analytics, insight and leadership to help promote injured worker safety, improve pharmacy savings and increase efficiencies of the pharmacy program.
You will support program-related short term and long term operational, product and/or technical solutions and strategies through guiding development of enhancements to improve end to end clinical process and systems decision making. We’ll also look to you, in collaboration with internal partners and our pharmacy benefit manager, to design and implement pharmacy solutions or internal business functions by providing clinically relevant research and analysis of pharmacy and related clinical data.
Liaison between external pharmacy partner and internal stakeholders and clinical management teamInteract with adjusters and clinical teams to drive best-practice adoption across the organization to achieve the best outcomesEducate internal and external peers and colleagues on clinical and pharmacy concerns, issues or trendsData analysis and reporting to provide understanding and effectiveness of programs and claimant outcomes to internal and external stakeholdersDevelop and maintain a strategic roadmap for the pharmacy program, aligning with overall business objectives and market trendsLead integration efforts between our internal systems and the external partner's platforms to ensure seamless data flow and operational efficiencyDevelopment of pharmacy trend reporting for management in conjunction with our pharmacy benefit managerAssist in the development of and track key performance indicators (KPIs) for the pharmacy program, using data-driven insights to drive continuous improvementWork with the external partner to identify and implement continuous improvement initiatives, leveraging best practices from both organizationsChampion user-centric design in all pharmacy program interfaces and processes, ensuring an optimal experience for internal and external usersCreate and maintain a structured collaboration framework with the external partner, including regular review meetings, joint planning sessions, and escalation proceduresAnticipates customer needs and proactively develops solutions to meet themEstablish and manage an innovation pipeline for the pharmacy program, including evaluation and implementation of new technologies and service models Qualifications 5+ years of leadership and program management or account management experienceStrong influencer with demonstrated skills in innovative thinkingProven experience leading and managing change initiativesExpert understanding of the clinical process and data integrity requirements using technologyStrong process improvement skills / experienceStrong interpersonal, communication and relationship building skills across multiple audiencesStrong data analytic and problem-solving skillsProficient with MS Office Suite: Excel, Word, PowerPoint, Outlook, Project and VisioAbility to hold individuals accountable and develop the ability to influence without authorityAbility to act as a consultant to product, operations and technology partnersWorkers’ compensation claims experience is preferred
Education
Bachelor’s degree in business or a related discipline, Master’s degree preferredA professional clinical degree or license is preferred Additional Company Details www.berkleymms.comThe Company is an equal employment opportunity employer
We do not accept any unsolicited resumes from external recruiting agencies or firms.
The company offers a competitive compensation plan and robust benefits package for full time regular employees.
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Additional Requirements Travel Requirements
• Domestic U.S. travel required (up to 10% of time)
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