VP Pharmacy Management at Medical Mutual in Cleveland, OH

Reports To: D. Bialecki-Haase

Location: Brooklyn, OH Hybrid, 4 days a week onsite

Salary Grade: VPA

Recruiter: L. Shinn

**Medical Mutual employees must submit their applications through MySource.

Develops and maintains strategies to manage pharmaceuticals that produce the best outcomes at the lowest cost. Creates plans for managing and measuring pharmacy utilization. Collaborates with various internal areas to plan, direct, and analyze pharmacy management and business development opportunities, analyze existing products, and identify emerging/leading edge products, services, or markets. Recommends a portfolio of market sensitive and cost-efficient products or services that support the Company's financial viability, marketability, maximum sales volume, and market share in accordance with corporate goals and objectives.

Responsibilities:

• Provides an overall definition of principal market requirements resulting in the formulation of the key strategies. Provides input to annual business plans for new/improved products, services, programs, business opportunities.
• Drive pharmacy benefit strategy and design. PBM relationship owner and oversight of PBM performance.
• Assesses the general effectiveness of cost reducing, service enhancing strategies, products, markets, and programs to increase business retention, ensure continued market responsiveness and improve customer satisfaction.
• Utilizes innovative solutions and constructive thinking to recognize product and market trends/directions within the industry to keep the Company on the leading edge of new products or markets. Identifies emerging market trends that may lead to product/service innovation.
• Collaborates with internal departments and other affected parties to help develop new/enhanced programs, products and services, promote overall business growth and manage pharmacy expense. Contributes to building physician incentive programs aimed at increasing pharmaceutical usage.
• Represents the Company as an Executive Officer to key customers and other external contacts. Stays abreast of pharmacy and payer industry changes.
• Negotiates and monitors contracts with outside vendorsincluding PBM. Reviews and approves budgets for functional operations under his/her control and administers his/her functional operations in accordance with budgeted goals and plans.
• Performs other duties as assigned.

Qualifications:

Education and Experience:

• Doctor of Pharmacy Degree.
• 10 years progressive pharmacy leadership experience at a health plan or pharmacy benefit manager (PBM).
• Experience with Medicare/Commercial/ACA.

Professional Certification(s):

• Registered Pharmacist in any state with unrestricted license and willingness to obtain Ohio License within 90 days.

Technical Skills and Knowledge:

• Comprehensive knowledge of Ohio Medicare/ACA, Pharmacy Benefit Management (PBM), managed care pharmacy, and health plan operations, and the ability to apply advanced concepts to Companywide strategy, policies, and procedures.
• Knowledge of formulary management and Medicare Part B and D regulations and guidelines.
• Knowledge of Request for Proposal (RFP) and Administrative Services Only (ASO) pharmacy sales.
• Intermediate to advanced Microsoft Office (Word, Excel and PowerPoint) and pharmacy systems skills; basic proficiency with Visio, Access and QMF for Windows.
• Ability to communicate and present to various internal and external audiences, including top management and board members.

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:

A Great Place to Work:

• Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
• On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
• Discounts at many places in and around town, just for being a Medical Mutual team member.
• The opportunity to earn cash rewards for shopping with our customers.
• Business casual attire, including jeans.

Excellent Benefits and Compensation:

• Annual bonus and Long-Term Incentive
• 401(k) with company match up to 4% and an additional company contribution.
• Health Savings Account with a company matching contribution.
• Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority.
• Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
• Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
• After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:

• Career development programs and classes.
• Mentoring and coaching to help you advance in your career.
• Tuition reimbursement up to $5,250 per year, the IRS maximum.
• Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:

Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.

There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.

We’re not just one of the largest health insurance companies based in Ohio, we’re also the longest running. Founded in 1934, we’re proud of our rich history with the communities where we live and work.

We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.

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