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Staff VP, Clinical Quality Pharmacy Services - IngenioRx

Location:

  • National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint

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Description

IngenioRx is a different kind of PBM. Harnessing our more than 30 years of pharmacy expertise, IngenioRx is actively defining our own innovative role in the industry. Leveraging the power of new technologies and a strong, clinical-first lens, IngenioRx is helping members and sponsors stay ahead of changes and maximize the value of personalized pharmacy care. For more about IngenioRx, go to  ingenio-rx.com

The incumbent in this role will be responsible for the administration of medical services for company health plans.

Location: Open to remote or within commutable distance to an office location

Responsible for leading the development, implementation, and maintenance of clinical services for the Pharmacy Benefits Manager (PBM) related to pharmacy quality programs.  

Primary duties may include, but are not limited to:

  • Oversees clinical research and development of programs designed to promote the use of effective drug therapies while managing drug spend

  • Models programs and analyzes data to help guide programming and formulary decisions

  • Responds to RFPs for internal and external business clients

  • Assists in the development of pharmacy benefits programs

  • Manages overall quality and support of the Health Plans accreditation including NCQA STARs for all lines of business

  • Designs, implements, and measures pharmacy initiatives to support Medicaid value-based, healthcare exchange and commercial business programs

  • Support PBM clinical portfolio for standalone clients and integration of new Anthem diversified business group opportunities for quality clinical programs

  • Serves as subject matter expert for pharmacy quality in the sales arena

  • Participates on pharmacy committees and develops relationships with key stakeholders

  • Hires, trains, coaches, counsels, and evaluates the performance of direct reports

Qualifications:
  • Requires a licensed clinician in applicable state; 8 years of experience in the PBM clinical pharmacy initiatives, including 3 years of management experience in leading clinical professionals and clinical program development; or any combination of education and experience, which would provide an equivalent background.

  • Must possess a broad understanding of key cost-of-care tools and quality standards and have an excellent understanding of industry trends and competition.

Preferred Skills, Capabilities, and Experiences:

  • Experience developing and implementing clinical pharmacy programs to meet health plan accreditation metrics and value-based programs

  • Leadership training through an employer or outside the company in communications, emotional intelligence, and/or executive presence

  • Experience collaborating with c-suite executives

  • MBA or MHA preferred


Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

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