Vp Government Programs Client Strategy

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

VP Government Programs Client Strategy

The Vice President of Government Programs Client Strategy is responsible for developing and executing comprehensive, integrated client-specific and data-driven growth strategies, focused on total cost of care, operational excellence, product innovation, and Star Ratings. This position drives clinical quality analytics and collaborates across the enterprise to advance Prime’s position in the Medicare and Managed Medicaid space and influences operational outcomes that drive superior Medicare/Medicaid member and client experience.

Responsibilities

• Other duties as assigned
• Establish and monitor a mechanism and methodology for remaining current on key trends affecting Medicare and Managed Medicaid benefit coverage issues and state and federal rules and regulations.
• Define clear and measurable objectives that coincide with strategic and operational initiatives and lead to the identification, development and expansion of client relationships and execute and track government programs key performance indicators (KPIs).
• Provide leadership and oversight to the client engagement support team to be a liaison between clients, account management, and internal stakeholders to effectively prioritize requests based on cost, resource availability, market factors and alignment to both Prime and client objectives and goals; leverage an intimate understanding of client priorities, market direction, and demand for new products/services in the marketplace to influence the development and deployment of market competitive solutions and engage effectively with key internal partners to deliver the expected outcomes while demonstrating sound financial stewardship.
• Establish goals that guarantee performance objectives are met and/or exceeded; instill a culture of compliance, accountability, and superior service within the Government Programs organization.
• Provide leadership and oversight to the Clinical Quality team and ensure execution of client-specific data-driven Star Ratings analysis and strategy to support performance improvement within Medicare.
• Establish key relationships with Government Program owners and executives at health plan clients, consultants, and other key external stakeholders to advocate for Prime’s government program offerings, align priorities, solicit feedback and recommendations, and create solutions to address interest, concern, or opportunity.
• Provide leadership to the Medicare and Managed Medicaid Center of Excellence team and oversee the development and execution of client-specific comprehensive playbooks leveraging Prime’s government programs extended actuary, network, trade, formulary, and operations teams.

Minimum Qualifications

• 15 years of relevant work experience in PBM, pharmacy, health plan and/or managed care with a minimum of 8 years in Medicare and/or Medicaid in a health plan, healthcare consulting firm, PBM, or other government environment
• Bachelor’s degree in Pharmacy, Analytics, Finance, Business, Health Care Administration, or related area of study
• 9 years of leadership/people management experience
• Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

• Proven track record of leadership with results in the healthcare industry and recognition for government program expertise; strong understanding of Medicare Part C and D rules and regulations
• Strategic thinking and long-range planning skills with the ability to design, execute, and link multiple projects over time to achieve a future strategic goal looking beyond the present situation to conceptualize key trends and identify changing market demands
• Exceptional client relationship management and cross-functional team building skills; ability to establish trust, build rapport, and collaborate effectively internally and externally and at various levels of an organization
• Excellent facilitation, communication, presentation, and consultative skills; demonstrated ability to distill complex concepts or situations into concise and compelling communications
• Strong skills in developing comprehensive strategy to drive growth in government programs (Medicare and/or Managed Medicaid)

Preferred Qualifications

• 5+ years of work experience in Pharmacy Benefit Management (PBM)
• Master’s degree or other advanced degree

Minimum Physical Job Requirements

• Occasionally required to stand, walk and stoop, kneel, and crouch
• Ability to travel up to 40% of the time
• Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
• Frequently required to reach with hands and arms
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus
• Constantly required to sit, use hands to handle or feel, talk and hear

Reporting Structures

• Reports to the Senior Vice President, Government Programs

Potential pay for this position ranges from $210,900.00 - $359,300.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected class under federal, state, or local law.