* Responsible for developing new and expanded third party payers prescription programs and oversees all aspects of the managed care process and payer relationships. Set business strategies on pharmacy sales growth, gross profit enhancement for specialty, home infusion and ambulatory pharmacy services.
1. Responsible for managed care sales plan development and execution including identification of local, regional and national payers which includes new and existing accounts requiring support to be obtained, executed or updated.
2. Evaluates, negotiates and manages performance of third-party contracts as well as provide strategies for maximizing revenues from these plans. Assure efficient and effective communication and implementation of Pharmacy¿s third party contract relationships.
3. Collaborates with Senior Management to develop and execute the national/regional/local business plans and assists with writing a business plan by including the health plan targets for the upcoming quarter and year.
4. Oversees financial, operational and delivery aspects of payer contracts including performing quarterly business reviews with contracted plans by monitoring contract consistency and compliance. Develop, recommend annual third party payer negotiation parameters and execute negotiations consistent with budget .
5. Interface with accounting department to identify and give direction in managing reimbursement/collections issues. Provide strategy in the development of reporting capabilities that can identify opportunities to increase collection rates.
6. Utilizes pharmacy operations expertise on third party plans to analyze opportunities and develop pharmacy programs to improve therapeutic outcomes, reduce overall pharmacy cost and enhance quality program initiatives .
Complexity of Work: This role requires critical thinking skills, effective communication, decisive judgment, and the ability to work with minimal supervision. The incumbent must be able to work in a stressful environment and take appropriate action when required.
Education: Graduate from an accredited school of Pharmacy.
Licensure, Certification and Registration: Florida state licensure as a Pharmacist.
Required Work Experience: Five (5) years experience in pharmacy administration, third party contracting, negotiating and business development.
Since the opening of the one-story, 100-bed Memorial Hospital in 1953, the South Florida community has benefited from caring and compassionate healthcare at Memorial Regional Hospital. Today, with 553 beds and as the flagship facility of Memorial Healthcare System, Memorial Regional Hospital is one of Florida’s largest and most sophisticated hospitals, offering leading-edge care and technologies. Services include:
• Medical and Surgical Services
• Emergency Room and Level I Trauma Center
• Memorial Cancer Institute
• Memorial Cardiac and Vascular Institute
• Memorial Neuroscience Institute
• The Family Birthplace
• Women’s Services
• Wasie Neonatal Intensive Care Unit
We are also home to a team of dedicated professionals, all of whom deliver nationally recognized, award-winning care. Memorial Regional Hospital has received Press Ganey’s Guardian of Excellence Award for Patient Satisfaction (Inpatient Behavioral Health) for three consecutive years, has been recognized by Truven Health Analytics as one of the nation’s 50 Top Cardiovascular Hospitals, and for the last seven years has received the Gold Plus Achievement Award from the American Stroke Association.
Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.
Employment at Memorial Healthcare System is subject to post offer, pre-placement assessment, including drug testing.
Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.
Location/Region: Hollywood, FL