Pharmacy Solutions Manager

🕒 il y a 1 mois

🐊 Florida – Distant

🐊 Florida – Remote

⏰ Temps Plein

🟠 Senior

🔴 Expert

💻 Ingénieur Solutions

👻 Score fantôme 10%

Ce que ça veut dire : la probabilité que cette offre reste ouverte sans recrutement actif.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Liviniti

Site WebLinkedInTous les Emplois

501 - 1000 employés

Fondée en 2011

🏥 Santé

⚕️ Assurance santé

💊 Pharmaceutique

Healthcare • Healthcare Insurance • Pharmaceuticals

Liviniti est un gestionnaire de prestations pharmaceutiques (PBM) agissant en tant qu'intermédiaire qui aide les employeurs et les systèmes de santé à réduire les coûts des médicaments sur ordonnance grâce à une tarification transparente, des programmes cliniques et des approvisionnements en médicaments. L'entreprise propose un transfert intégral des rabais (100% rebate pass-through), des frais administratifs fixes, un accès détaillé aux réclamations et aux remises pour une visibilité totale, des formulaires et réseaux personnalisables, une autorisation préalable centrée sur le coût net le plus bas, ainsi que des solutions spécialisées comme LivLite pour la gestion des médicaments amaigrissants GLP-1. Liviniti met l'accent sur le service B2B, la valeur clinique et l'innovation continue pour réduire les dépenses pharmaceutiques tout en maintenant le soutien et le service aux membres.

Description

• 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%

🎯 Exigences

• 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

🏖️ Avantages

• 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