Job Information
WellSense Pharmacy Program Manager in United States
Pharmacy Program Manager
WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, we provide plans and services that work for our members, no matter their circumstances.
Apply now (https://jobs.silkroad.com/BMCHP/Careers/Apply/MultiForm/294263)
It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.
Reporting to the Senior Director of Pharmacy Services, the Pharmacy Program Manager is primarily responsible for pharmacy benefits configuration, including operational implementations in accordance with accreditation and regulatory requirements, as well as other processes and/or programs in support of regulatory requirements for all lines of business. The Pharmacy Program Manager also provides project management support across all pharmacy services initiatives that include both clinical and operational initiatives in support contractual obligations and fiscal goals. Additionally, documentation of policies, procedures, and programs shall be required.
Our Investment in You:
Full-time remote work
Competitive salaries
Excellent benefits
Key Functions/Responsibilities:
Responsible for accurate and timely implementations of pharmacy benefits and operations configurations
Provides project management support for all pharmacy services initiatives across all lines of business
Responsible for initiation, planning, tracking, documenting, execution, and monitoring and controlling of program implementations
Proactively works with the project teams to identify and resolve issues, escalating when necessary to business owners and executive sponsors to work through obstacles and ensure project is executed successfully
Interfaces with all areas affected by the project including end users and vendors
Responsible for documentation of policies, procedures, and program designs in support of clinical, operational, and regulatory requirements
Responsible for validation of benefits configurations
Collaborates cross-functionally with both internal and external partners to support all projects and initiatives
Participates on committees and/or lead cross-functional workgroups as necessary
No direct supervision exercised but may be responsible for managing 10 – 20 FTEs on project teams
Other duties as assigned
Qualifications:
Must be experienced with project management processes, tools and templates, as well as project team roles and responsibilities
Excellent written and oral communication skills
Excellent interpersonal skills
Strong organizational and time management skills, including ability to work independently and prioritize multiple projects and assignments
Able to collaborate cross-functionally
Ability to develop and support data dashboards
Ability to analyze, compile, format, and present findings, data, queries, and reports to a variety of stakeholders
Demonstrates ability to provide guidance and oversight
Demonstrated strength in analysis, identification of problems and issue resolution
Excellent skills in teamwork and team approaches to goal setting and attainment
Must be results oriented
Education & Experience:
Minimum of professional bachelor’s degree in health care administration, public health or related field required
Graduate study in a business, public health, or health policy field will be favorably considered
Project management experience required
Pharmacy industry experience highly preferred
Experience with systems configurations and strong understanding of claims data
Experience in a managed care setting, either from the provider, the payer, or the PBM side of the industry, is preferred
Proficiency in standard computational office-suite applications, including project, word-processing and relational database manipulation is required
Competencies, Skills, and Attributes :
Strong operational experience
Familiar with regulatory requirements and accreditation standards
Organized, with clear communication skills
Ability to parse through problem statements and identify resolution
Working Conditions and Physical Effort:
Regular and reliable attendance is an essential function of the position
Occasional travel (<5%) may be required
Ability to work in a fast paced environment
About WellSense
WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances.
Apply now (https://jobs.silkroad.com/BMCHP/Careers/Apply/MultiForm/294263)
Important info on employment offer scams:
According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not reach out to individuals via text, we do not ask or require downloads of any applications, or “apps”, and applicant screenings, interviews and job offers are not conducted over text messages or social media platforms. We do not ask individuals to purchase equipment for, or prior to employment. To avoid becoming a victim of an employment offer scam, please followthese tips from the FTC (https://consumer.ftc.gov/consumer-alerts/2023/01/looking-job-scammers-might-be-looking-you?utm_source=govdelivery) .
Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees.