Pharmacy Services Contract Manager

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Pharmacy Services Contract Manager
The candidate will be responsible for the effective management of assigned contractual associations with payers, vendors, and pharmaceutical companies. Will be the liaison between firm's Pharmacies and the payer, pharmacy benefit manger, vendor, or pharmaceutical companies and works to establish genuine, sincere and long-term, community oriented business relationships. Will be strategic lead on payer accounts and must continually assess and evaluate the association suggesting opportunities to refine and improve the relationship. Will ensure that contract language is consistent with contracting standards and does not pose significant financial, legal, compliance/privacy, administrative, or political risk for Intermountain's Pharmacies. Also responsible for the complete and effective management and/or resolution of department and organization projects as assigned by the directors or assistant vice president. The manager must be conversant with industry developments and proactively propose evolving contract strategies to ensure contracts remain relevant and beneficial to firm's Pharmacies. The manager also acts as the liaison between contracted entities and firm Pharmacy Services with personal and professional confidence. Duties : Establishes and Maintains Effective Long-term Payer Associations: Works effectively with payers, pharmacy benefit managers, suppliers, and pharmaceutical companies to establish long-term and sincere business associations. Acts as an advocate in issues resolution, while still maintaining consistency with established policies and keeping Intermountain's Pharmacy Services best interests in focus. Reaches out to potential partners in an effective and strategic manner to ensure the association is mutually beneficial. Ensures that Intermountain's Pharmacy Services commitment to the community is advanced through the establishment and retention of mutually beneficial contracts with various entities. Manages Contractual Associations: Ensures that all contracts are properly drafted and executed and that terms and conditions are fair and consistent with other payers, suppliers, or pharmaceutical companies. Accountable for financial performance and contract compliance through conducting regular audits of previously executed contracts by Intermountain's Pharmacy Services Group. Acts as a lead in contract negotiations and on all pharmacy payer accounts and effectively and skillfully represents Intermountain and Intermountain Pharmacy Services to finalize favorable contracts for the organization and department. Effectively manages coordination efforts between Compliance, Legal, Information Systems, Pharmacy, ISSA, EISA, Risk Management, Supply Chain Center, Payer Contracting, and any other Intermountain entity involved in the contracting process. Should possess a strong and increasing working knowledge of the contracting process between Intermountain payers, pharmacy benefit managers, suppliers, and pharmaceutical companies, and acts as a subject matter expert and resource to others. Communicates Intermountain policies and procedures to contracted or potential contracted entities. Responds confidently and skillfully to inquiries and provides answers and information as appropriate to ensure clarity and efficiency. Takes responsibility to ensure contracts can be executed in a timely manner. Demonstrates a solid and strong working knowledge of pharmacy payment methodologies for commercial and government payers and ensures that department processes are aligned with such programs. Maintains a current understanding of contracting issues and takes efforts to keep current in industry intelligence. Champions new strategies / initiatives with payers, pharmaceutical companies, vendors, and with system stakeholders, as assigned. Possesses a working knowledge of government healthcare plans and applies current requirements to those contracts. Champions and advocates for effective contracts. Demonstrates a skilled understanding of commercial insurance, particularly for the specific benefit plan designs, payment structures, and insurance offerings represented by assigned payers and incorporates that knowledge into those contracts in order to ensure effectiveness. Understands compliance issues with respect to PHI, Stark, and other regulatory issues. Acts as a liaison with compliance, legal, and pharmacy to ensure contracts are established that mitigate risk for all entities. Provides frequent status updates to various levels of the organization including, Pharmacy leadership, and staff.

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