Head of Medicare Pharmacy Operations - 136726

Company: Anthem, Inc. ( Learn More )

General Information
US-RI-Providence
N/A
Not Specified
Full-Time
Not Specified
None
True
False
Job Description Anthem, Inc. is the nation's leading health benefits company serving the needs of approximately 40 million medical members nationwide. Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.
 
This is an exceptional opportunity to do innovative work that means more to you and those we serve atone of America's leading health benefits companies and a Fortune Top 50 Company.

Leads Medicare Pharmacy Operations organization that administers Medicare pharmacy benefits for Part B, C and D members. Primary duties may include, but are not limited to:
  • Oversees all operational pharmacy issues, facilitates resolution of issues and ensures CMS and contract metrics are met.
  • Develops, implements and tracks all operational plans to successfully support growth in a Best-in Class Compliance environment.
  • Identify areas of opportunity to increase efficiency and maximize revenue opportunities and drive improved results based on continuous improvement assessments and flawless execution.
  • Oversees all activities of any outsourced Pharmacy Benefits Managers account management, operations and leadership teams.
  • Works with product to develop Medicare products aligned with needs and are compliant with CMS and can be administered by Pharmacy Benefits Managers while being in compliance with contract and performance guarantees.
  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.
  • Job Requirements
    • Requires BA/BS degree in a related field; Masters preferred; 15-20 years professional experience in a managed care or related environment with at least 5-10 years of operational experience in the PBM space.   
    • Ability to masterfully represent the Department with executives and external constituencies necessary.  
    • Deep Medicare program experience and fluency are essential
     
     

    Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.