As one of the nation’s largest not-for-profit Medicare Advantage plans, serving more than 200,000 members in California, SCAN Health Plan has been a mission-driven organization dedicated to keeping seniors healthy and independent for over 40 years. SCAN employees are passionate about what they do, and understand that success is based on achieving the mission. Employees are afforded with the training and tools necessary to do their jobs and are rewarded for their efforts and recognized as experts in their fields. To learn more, visit scanhealthplan.comor follow us on social media:LinkedIn; Facebook; andTwitter.
Develop and execute on pharmacy strategy through analytics, research and financial management of prescription drug benefit in support SCAN business needs as it relates to cost, operations and clinical management.
Direct quantitative analysis and data mining projects to uncover opportunities that improve quality, cost, and efficiency and execute on applicable opportunities with pharmacy leadership and organization.
Oversee the timely delivery of monthly department financial/utilization package, analyzing, understanding and communicating with Finance, Actuary, Accounting and Pharmacy Management on monthly utilization and drug budget variances.
Oversee and provide leadership to the research and analysis team. Direct workflow, assign projects, and provide direction to ensure timely, high quality products that meet the needs of the department or customer. Guide areas of pharmacy research, thought leadership and publication.
Responsible for Pharmacy Benefit Manager (PBM) administration budget forecast, invoice management and performance guarantee reconciliation.
Develop and oversee the specific strategic and tactical initiatives designed to optimize pharmacy/organizational performance.
Oversee IT Portfolio Requests for the department and manage relationship and execution progress with IT.
Collaborate with IT / Data Governance as the pharmacy data subject matter expert.
Ensure staff results by communicating job expectations; planning, monitoring, and appraising job results; coaching and counseling employees; initiating, coordinating, and enforcing systems, policies, and procedures.
Maintain staff by recruiting, selecting, orienting, and training employees; maintaining a safe and secure work environment; and developing personal growth opportunities.
Maintain professional and technical knowledge by attending educational workshops; reviewing professional publications; maintaining personal networks.
Ensures operational needs are met by performing complex analyses on a wide range of organizational data - investigates and uncovers root cause, identifies trends, etc. and proposes solutions.
Master's Degree in Business Administration, Statistics, Economics, Mathematics or related field required.
7+ years of pharmacy managed care experience required.
4+ years of Medicare Part D experience required.
Medicare Star Rating experience (preferred).
Demonstrated management experience.
Strong interpersonal skills, including excellent written and communication skills.
Excellent organizational, decision-making, and multi-tasking skills.
Ability to prioritize multiple and competing tasks, work independently and in a team environment.
Expertise in mining healthcare data, including but not limited to, eligibility, encounters, pharmacy claims, industry drug databases, provider, PDE and financial data.
What's in it for you?
A competitive compensation and benefits program
An annual employee bonus program
Generous paid-time-off (PTO)
Ten paid holidays per year
Excellent 403(b) Saving Plan, providing up to 4 % match and vesting after three years
A Work - life balance and much more!
At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.
SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employee will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.
Telecommuting is allowed.
Internal Number: DIREC03599
About SCAN Health Plan
As one of the nation’s largest not-for-profit Medicare Advantage plans, serving more than 200,000 members in California, SCAN Health Plan has been a mission-driven organization dedicated to keeping seniors healthy and independent for over 40 years. SCAN employees are passionate about what they do, and understand that success is based on achieving the mission. Employees are afforded with the training and tools necessary to do their jobs and are rewarded for their efforts and recognized as experts in their fields. To learn more, visit scanhealthplan.com or follow us on social media: LinkedIn; Facebook; and Twitter.