This leadership position is responsible for managing workload, capacity, and workflow, while ensuring client expectations and performance guarantees are met, for a Benefit Plan Administration client support team. These teams are comprised of Benefit Design Analysts, Benefit Design Specialists, and Quality Assurance staff. The client support teams are accountable for implementing, maintaining, and quality testing our clients’ pharmacy benefit programs, including both the creation of plan elements and the plan build itself; they are also responsible for supporting client project requests and acting as SMEs on internal Roadmap and FastTrack projects.
This position will share accountability with peer Benefit Plan Administration Managers for implementing quality improvement initiatives and maintaining consistent processes and procedures to ensure member and client satisfaction. This position will also share accountability with the Benefit Operations Sr. Pharmacist to ensure client requested projects and plan changes are implemented in a timely manner and with high quality.
· Provide tactical leadership and take accountability for the performance of the Benefit Plan Administration client support teams.
· Establish and maintain partnerships with the Ben Ops Senior Pharmacists overseeing Benefit Plan Administration pharmacist teams. Develop a collaborative relationship and solid communication methods with the Sr. Pharmacist supporting the same client team.
· Establish and maintain partnership with the Manager of Benefit Support for quality and performance measurement of Benefit Plan Administration staff, including collaboration on metrics, training, audit, system application, and automation needs.
· Manage and monitor capacity, including managing project demand, estimating support demand, and managing resources to support both. Collaborate with peers for cross-functional support of commercial Benefit Operations work items.
· Provide leadership and collaboration for cross-functional departmental efforts to improve accuracy, consistency, and efficiency.
· Instill a culture of continuous quality improvement by providing the methods and tools and by setting objectives to continually evaluate and improve processes and procedures to ensure the operations meet Clients’ requirements in an efficient manner through measures of cost reduction, improved productivity, improved turnaround time and increased quality.
· Establish and maintain productive relationships with clients, Client Engagement, and other internal stakeholders. Represent Prime at client meetings.
· Ensure staff knowledge remains current with client specific requirements, and processes and procedures are modified as necessary to accurately reflect all requirements.
· Ensure client performance guarantees are met related to areas of responsibility. Provide key performance indicators to leadership.
· Provide leadership, mentoring, and personal growth and development opportunities to the staff in alignment with required skills. Provide consistent feedback to staff, including performance statistics.
· Support the review and testing of enhancements to RxCLAIM, BET, BATT, and other systems related to the commercial production area. Disseminate knowledge of system changes to staff. Ensure staff uses available systems efficiently.
· Resolve escalated client and/or member issues related to benefit design and set up.
· Other duties as assigned
· Some travel required.
· Bachelor’s degree or equivalent experience.
· 3 -5 years of professional work experience
· 3 - 5 years experience supervising staff or managing projects.
· Ability to manage multiple, complex activities simultaneously without compromising quality.
· Ability to work under pressure and strict timeframes.
· Strong interpersonal communication skills, including team leadership, conflict resolution and listening.
· PBM or Managed Healthcare background.
· Ability to effectively lead a team to meet client performance guarantees for quality results and compliance with regulatory guidance.
· Experience working directly with clients.
· Excellent verbal and written communication skills.
· Proficiency in Microsoft Word, Excel, Access, Lotus Notes experience desired.
Prime's fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in the health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.
If you are looking to advance your career within a growing and team-oriented company, apply to Prime today and start making a difference.
We are proud to be an EOE/AA employer. We maintain a drug-free and tobacco-free workplace and perform pre-employment substance abuse testing.
Prime Therapeutics (Prime) is a thought leader in pharmacy benefit management. We help clients make smart health care management decisions...