Pharmacy Solutions Manager

🕒 Agosto 13

🐊 Florida – Remoto

🐊 Florida – Remote

⏰ Tempo Integral

🟠 Sênior

🔴 Especialista

💻 Engenheiro de Soluções

👻 Score fantasma 10%

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Liviniti

SiteLinkedInTodas as Vagas

501 - 1000 funcionários

Fundada em 2011

🏥 Saúde

⚕️ Seguro de Saúde

💊 Farmacêutico

Healthcare • Healthcare Insurance • Pharmaceuticals

A Liviniti é uma gestora de benefícios farmacêuticos (PBM) que ajuda empregadores e sistemas de saúde a reduzir os custos de medicamentos prescritos por meio de preços transparentes, programas clínicos e fornecimento de medicamentos. A empresa oferece repasse de 100% dos rebates, uma taxa administrativa fixa, acesso a detalhes de sinistros e rebates para total transparência, fórmulas e redes personalizáveis, autorização prévia focada no menor custo líquido e soluções especializadas como o LivLite para gerenciamento de medicamentos para perda de peso GLP-1. A Liviniti enfatiza o serviço B2B, valor clínico e inovação contínua para reduzir os gastos com farmácia enquanto mantém apoio e serviço aos membros.

Descrição

• Lead onboarding and setup of Health System owned/affiliated pharmacies, including participation records, credentialing documentation, system configuration, and Payment-Remit setup communications • Validate pharmacy data and setup accuracy through quality checks and audits, correcting discrepancies affecting claims, payments, or reporting • Lead pharmacy-partner communications, collect and maintain pharmacy records, agreements, and correspondence • Resolve escalated pharmacy participation and communication issues and serve as a trusted point of contact for pharmacy partners • Participate in implementation meetings and communicate timelines, problems, questions, and pertinent information • Assist with development, rollout, and ongoing management of specialized pharmacy programs and provider communications • Support network strategy, RFP responses, new client implementations, access analyses, gap analyses, and disruption analyses • Partner with Clinical, Operations, Account Management, and Network teams across the client lifecycle • Develop SOPs, workflows, job aids, and internal training materials; implement process improvements • Produce pharmacy-specific reporting and actionable insights on participation, performance, and program impact • Track department ticket queues, monitor service levels and guarantee items, flag risks, and drive corrective action • Ensure regulatory, contractual, and HIPAA compliance; report HIPAA violations and complete required HIPAA training • Provide leadership and oversight for the department, including supervision of managers and directors • Travel approximately 30%

🎯 Requisitos

• Active pharmacist licensure • Doctor of Pharmacy (PharmD) • Minimum seven years of progressive experience in pharmacy network operations, PBM operations, managed care, healthcare compliance, regulatory affairs, audit management, or related areas • Two years of relevant PBM experience • Hospital health system experience • Experience managing regulatory submissions, audits, corrective action plans, compliance monitoring, or regulator-facing responses • Proven ability to work cross-functionally with Legal, Compliance, Operations, IT, Network, and senior leadership • Project management and organizational rigor • Technical capacity • Problem solving and analysis • Strong written and spoken communication • Self-learning ability • Cross-functional collaboration • Program and process development and oversight • Ability to work core hours from 8:00 AM to 5:00 PM CT and adjust work times for meetings across time zones • Ability to work extended hours, weekends, and holidays as industry demands • Preferred: Bachelor’s degree in a related field • Preferred: two years’ experience in a health care related field • Preferred: two years’ experience in business analysis • Preferred: advanced degree such as MBA, MHA, PharmD, JD, or related graduate degree • Preferred: healthcare compliance, pharmacy technician, or related professional certification • Strongly preferred: PBM, health plan, managed care, pharmacy network, or regulator-facing experience • Preferred: leadership experience building or improving compliance programs, audit processes, tracking tools, or governance frameworks

🏖️ Benefícios

• Medical, Dental and Vision Insurance • Disability and Life Insurance • Employee Assistance Program • Remote work options • Generous Paid-Time off • Annual reviews and development plans • Retirement Plan with company match immediately 100% vested