Banner Health Sr. Director Managed Pharmacy Solutions in Phoenix, Arizona

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About Banner Pharmacy Services

Banner Pharmacy Services division provides excellent patient care across our entire continuum through convenient access, improved medication outcomes and innovative pharmacy practices. Banner Pharmacy Services will be recognized nationally as a clinical leader and trusted partner in proactively providing innovative pharmacy services through excellence in integration, care coordination, medication management and service to make a difference in people's lives. Banner is expanding its focus from being a hospital company to a clinical quality company focused on population health management. Clinical Pharmacy Services are also included in this robust new service line and are responsible for the management of the Banner formulary, development of standardized system wide clinical pharmacy services, and management of adverse drug event preventions. Clinical Pharmacy Services provides collaborative drug therapy management and educational interventions in patient care to optimize medication therapy, improve outcomes, promote wellness, and disease prevention.

About Banner Health

Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.

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Job Summary

Provides oversight and direction to Banner Health contracted Pharmacy Benefits Management (PBM) in order to affect optimal medication management and cost savings to the Banner Health pharmacy benefit plan and its members. Identifies and promotes the needed changes to Banner Health Benefits, Banner Plan Administration, and BPS leadership in formulary management, pharmacy medical management process, financial stewardship, and provider and employee communication. Provides direct management to PBM staff.

Essential Functions

  • Coordinates and monitors all functions of the contracted Pharmacy Benefit Management (PBM), which includes Pharmacy & Therapeutics (P&T) Committee activities, pharmacy utilization management, policies and procedures for the administration of outpatient drug benefits, coordination of Supply Chain and Pharmacy Services through the Sr Director of Preparation and Dispensing in their contracting efforts, and all other functions that encompass PBM services.

  • Coordinates, manages, and monitors the pharmacy benefit expense budget, as well as the pharmacy expense in the medical benefit. This includes coordination of the medication fee schedules that include: the MAC list for pricing of generic drugs, J-code fee schedules for use in physician offices, retail pharmacies, specialty pharmacies, home health and infusion centers.

  • Ensures coordination, education and communication of pharmacy benefit management (PBM) programs including P&T Committee activities, physician communication/education (includes contracting information to help improve formulary support, appropriate generic usage and improve outcomes), retail/community pharmacy, clinical intervention programs, drug usage evaluation programs, and pharmacy outcomes research.

  • Coordinates the development and implementation of educational support for physicians, patients, allied health personnel, contracted pharmacy partners and Pharmacy Services staff.

  • Reviews Drug Utilization Reports (DUR) and provides physicians with profile reports on prescription practices.

  • Participate with BPA and Banner Benefits departments in the development, implementation, evaluation, and marketing of medication related health and wellness programs that reduce health risk, enhance health status, reduce medical expense, and contribute to employee satisfaction.

  • Collaborates and communicates regarding issues, activities, clinical intervention programs and health related community/employer events.

  • Analyzes pharmacy claims, purchasing data, hospital system data to identify areas of utilization aberrations, opportunities for cost-efficiencies (including the creation and maintenance of all financial reporting controls relative to PBM functions and oversight of the rebate processes), prior authorization protocols, and identify where the organization should explore new and revised contracting and promotional activities.

Minimum Qualifications

Bachelors Degree in a relevant field or equivalent level of education and experience. Expert-level working knowledge of principles, practices, and operations in assigned or related area of responsibility as normally obtained through a minimum of five years of progressively responsible managerial experience, including a minimum of two years management level experience within a healthcare system setting or large multi-operational, complex corporate environment.

Depending upon assigned area of responsibility, position may require applicable certifications and/or licensures, including but not limited to: RN; MD or DO; Drivers License; Certified Healthcare Protection Administrator (CHPA); Certified Protection Professional (CPP); Chartered Property Casualty Underwriter (CPCU); Associate in Risk Management (ARM); CPA; SPHR; Registered Health Information Administrator (RHIA); Registered Health Information Technologist (RHIT); Certified Healthcare Facility Manager (CHFM); Certified Facility Manager (CFM); Certified Coding Specialist (CCS); Certified Professional Coder (CPC); JD from an American Bar Association accredited school; admission to a State Bar Association.

Must demonstrate expert-level knowledge and awareness of area of expertise in designated facility, business entity or area and/or experience in which the knowledge, skills, and abilities are directly transferrable. Proven track record of driving successful performance outcomes and accomplishing organizational goals. Must demonstrate skills and business acumen through direct leadership experiences such as: Anticipating and responding to the needs of internal and external customers; managing a budget and financial plans; building partnerships with management, staff, and stakeholders to achieve department goals and objectives; managing problems and situations where uncertainty is inherent; persuading others to adopt a particular stance on an issue; developing and evaluating best practices and emerging trends for organizational applicability and appropriateness; constructing new and innovative solutions for complex and varying problems and situations while considering the larger perspective or context; mentoring and coaching staff by providing open and honest feedback to enhance performance; developing and implementing strategic goals and initiatives that support organizational success; demonstrating excellent human relations, organizational and communication skills; demonstrating a passion about continuously improving and providing high quality care and service excellence to customers, patients, families, employees and/or physicians.

Preferred Qualifications

Pharmacy Benefits Management experience in a managed care setting is preferred.Advanced degree in Business Management or Healthcare Administration preferred.Strong health care systems orientation including: managed care, retail and hospital pharmacy, and pharmaceutical company contracting.Strong verbal and written communication skills.Personal computer skills including word processing and spreadsheets.

Additional related education and/or experience preferred.

Job Number 207897

Facility Banner Pharmacy Services

Shift Day

Department Banner Pharmacy Services - Pharm Benefits Mgmt

Position Type FT: Full-Time

Street Address 1441 N, 12th St.

City & State US-AZ-Phoenix

Posting Category Executive - Non-Clinical