Blue Cross Blue Shield of Massachusetts Pharmacy Program Manager in Hingham, Massachusetts
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The Pharmacy Program Manager is responsible for management and maintenance of programs, offerings and vendors that support pharmacy clinical and trend strategies to ensure execution and outcome goals are met. This position will be the key subject matter expert for the operational functions associated with pharmacy vendor partners and offerings including but not limited to issue management, reporting and oversight of service metrics. The Program Manager will collaborate with multiple business areas across the organization to support ongoing oversight and monitoring of the programs within the BCBSMA pharmacy benefit as well as for client specific offerings
Responsible for all program activities including day to day monitoring of performance, issue management, reporting and trend identification for both internal and external use
Responsible for ongoing performance tracking, report generation and quality control of data, identifying issues and/or concerns with performance metrics and monitoring service levels/performance guarantees
Responsible for management of all contract maintenance, NDAs, and invoicing for vendor partnerships
Serve as program subject matter expert for all Pharmacy programs, offerings, and vendor relationships
Support program development and implementation of new programs, offerings, or vendor relationships.
Support the development of educational pieces, tools and trainings for internal stakeholders
Support client implementation teams and workgroups to onboard new and renewal accounts into pharmacy programs/offerings
Work closely with and develop strong relationships with internal partners such as Product Management, Claims Operations, Enrollment Operations, Actuarial, Underwriting, Contracts Development, Finance, Member and Provider Service, Marketing, and Sales to ensure that mutual needs are met.
Support multiple projects and workgroups simultaneously, collaboratively working with internal and external key functional areas to support and advance the ongoing development of the pharmacy programs to achieve corporate and department goals
Other projects as assigned
Qualifications:Â (Knowledge, skills and abilities)
Demonstrates excellent oral and written communications through issue management activities, analysis and report generation, correspondence, presentation development and service level monitoring.
Ability to manage and prioritize multiple programs and meet deliverables
Collaborative by nature and a problem solver who thrives in a fast-paced environment.
A self-motivator who can gather, interpret and distribute information quickly and clearly both verbally and in writing.
Develop and maintain effective working relationships and provide high quality service with key internal customers and external vendor partners.
Ability to differentiate between important and urgent deliverables, request and issues.
Ability to engender trust and confidence; high sense of integrity and ethics.
Detail oriented with the ability to resolve complex problems and issues independently.
Bachelorâs Degree in business, finance or health related industry
5+ years relevant industry experience â managed care and/or pharmacy preferred.Â Â
Experience in management of business functions, vendor management, Â data analysis and/or project management.
Previous experience with pharmacy benefit management programs and/or health data analysis and reporting a plus
Computer and Software Skills: MS Outlook, MS Word, MS Excel, MS PowerPoint, MS Access, Foundation 14, OLB, Data Bases; Data Warehouse; SharePoint a plus.
LocationHinghamTime TypeFull time
Voted as the highest in member satisfaction among Massachusetts commercial health plans by JD Power , Blue Cross Blue Shield of Massachusetts is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We have been a market leader for over 75 years, and are consistently ranked among the nation's best health plans. Our daily efforts are dedicated to effectively serving our 2.8 million members, and consistently offering security, stability, and peace of mind to both our members and associates.
Our Commitment to You
We are committed to investing in your development and providing the necessary resources to enable your success. We are dedicated to creating a refreshing and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path. We take pride in our diverse, community-centric, wellness-focused culture and believe every member of our team deserves to enjoy a positive work-life balance.
Blue Cross Blue Shield of Massachusetts is an Equal Employment / Affirmative Action Employer. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law.
Blue Cross Blue Shield of Massachusetts will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with Blue Cross Blue Shield of Massachusetts's legal duty to furnish information.