Job: Associate Director, Pharmacy Benefit for Medicare/Medicaid Integrated Product
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This individual is responsible for the development and on-going management and administration of the Pharmacy program for the Medicare Medicaid (MME) integrated Plans.
In this key role you will manage and coordinate all activities related to the operations functions for the MME Pharmacy program, ensuring operational contract compliance.
Read, analyze and interpret State or CMS contracts and Plan requirements, Plan and or company policy and procedure and SOPs. Incorporates requirements into operational policies and procedures as necessary.
Oversee and perform various administrative/operational functions to support the MME integrated Plans, staff MME training, reporting oversight, audit
Serves as a resource to the Health Plans for MME Pharmacy by effectively working the company matrix to obtain resources, solve problems and foster communication
Builds self-directed work teams with autonomy and accountability for own goals/targets
Translate, support and promote organizational goals into specific goals and objectives for staff
Develop and conduct programs that support and improve quality management and maintain compliance with state Medicaid and CMS regulatory requirements
Establish and maintain effective working relationships with internal UHG business partners to ensure optimal operational effectiveness and contractual requirements are met.
Operational P&P - prepare regulatory framework for pharmacy program changes
Formulary development submission oversight and management for MME
Coordination with Part-D infrastructure to support MME programs
- B.S. Business, B.S. Pharmacy or PharmD. or equivalent experience.
- Prior Medicaid-Medicare Management experience preferred
- Proficient in Microsoft Office including Word, Excel, Power Point, Viso and Project Plan
- End-to-end project management experience a plus
UnitedHealthcare Community & State is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare Community & State.
We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.
This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.
You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Skills / Requirements