Vice President, Chief Pharmacy Officer - Des Moines, United States - Wellmark, Inc.

Description

Job Description

Wellmark is partnering with Solomon Page on this search. To learn more and/or to be considered, please contact Marc Gouran at .

Why Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we've built our reputation on over 80 years' worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you're passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today

Learn more about our unique benefit offerings here.

Want to know more? You can learn about life at Wellmark here.

About the opportunity: The Vice President, Chief Pharmacy Officer is responsible for the strategic direction, growth, implementation, retention, and leadership of an innovative, multi-faceted pharmacy program, in alignment with enterprise strategies.

The Vice President, Chief Pharmacy Officer will provide overall leadership and pharmacy direction across all lines of Wellmark's health plan business. This includes driving delivery of the pharmacy program to enhance affordability for both pharmacy and medical benefit drugs as well as program optionality for self-funded clients. This executive will work closely with SVPs and VPs across multiple Wellmark functions, including Sales, Product and Client Solutions, Health Networks and Innovation, Medicare Advantage, and Health Services to exceed customer expectations.

The Vice President, Chief Pharmacy Officer ensures that Wellmark's PBM meets or exceeds commitments for service and quality and drives member and physician engagement with pharmacy services to measurably improve satisfaction. This executive will be responsible for thought leadership in pharmacy innovation to improve key quality and service results and will build, inspire, and engage a high-performance team to serve Wellmark's members and customers.

Required:

• Bachelor's degree or direct and applicable work experience required. RPh or PharmD highly preferred but not required.
• Ten-plus years of progressive leadership experience within a health plan or PBM.
• Formal or informal leadership experience. Ability to effectively guide others, modeling adaptability, and inspiring strong organizational performance through periods of transformation, ambiguity, and complexity.
• Must demonstrate success in effectively managing a PBM/health plan relationship.
• Must be a naturally curious, collaborative leader with the ability to drive change and successfully work within a matrix environment. Demonstrated achievement in creating and fostering collaborative, high performing teams that produce results.
• Experience evaluating, tailoring, and developing integrated pharmacy programs and executing strategies to maximize pharmacy benefit savings. Ability to develop a strategy and communicate vision to team, senior leaders, organization-wide, externally, etc.
• Experience in overseeing multiple lines of pharmacy operations, preferably in a health plan.
• Strong knowledge and experience working with legislative and regulatory bodies in addition to state pharmacy associations.
• Comprehensive understanding of the managed care industry, including medical policy development, and the need as a health insurer to establish a balance within policy of the appropriate level of care for an individual and the overall pool of insureds.
• Broad understanding of the health care delivery system and pharmacy trends and methods to impact those trends, successful track record in managing pharmacy spend and pricing.
• Prior experience working with value-based contracting to include full capitation and Medicare Advantage. Understands how value-based pharmacy and provider agreements work together.
• Experience building and maintaining constructive, collaborative, and effective relationships with providers, and internal stakeholders, and a relentless passion for customers and members.
• Demonstrated understanding and experience utilizing process improvements to create operational efficiencies, effectively use resources, and improve outcomes for patients and providers.
• Deep content knowledge/experience leading health plan pharmacy as an enterprise value- driver preferred.
• Transparent, relational leadership style with the ability to communicate and work well with people at all levels.
• An extremely organized, data-driven, disciplined, hands-on, and process-oriented leader who is not afraid of digging into details when necessary.
• Highly engaged, energetic, focused, community-minded, socially responsible and execution oriented.
• Strategic vision and thinking. Ability to position the organization for the future, looking beyond the present situation to conceptualize key trends and identify changing market demands.
• Strong business acumen, intelligence, and capacity; able to think strategically and implement tactically.
• Open leadership style. Actively seeks out and supports collaborative thinking and problem solving with others in the organization.
• At Wellmark, compliance is everyone's responsibility. The incumbent is expected to model and embody the Wellmark values and abide by the Conduct and Ethics guidelines in the Wellmark Staff Guide. As an extension of this commitment, the incumbent shall discharge all of their responsibilities in compliance with the spirit and letter of the laws, regulations and standards governing them.

Job Responsibilities:

a. Develop and execute pharmacy strategies that align with the corporate and divisional objectives. Strategies focus on developing and defining procedures and systems to support and achieve high pharmacy carve-in rates, and long-term goals and measures that are consistent with Wellmark's Making Health Care Better strategy.

b. Cascade and communicate strategy and initiatives to Wellmark business owners, team members, customers, and stakeholders. Provide strong leadership to motivate team and build trust. Provide strategic oversight to the Pharmacy & Therapeutics (P&T) committee as needed.

c. Focus on delivering, in aggregate, the lowest net spend and trend through greater engagement with providers and members, targeted clinical programs, and an outsourced Pharmacy Benefits Manager (PBM) relationship.

d. Lead the design and implementation of continuous improvements and enhancements of the Pharmacy program (including the benefit designs, formularies, etc.) using data and analytics. Assure lowest net spend and trend vs. market competitors while optimizing members pharmaceutical value and improving efficiency and service levels.

e. Provide pharmacy direction and input to cross-functional teams to inform product development and innovation; provide pharmacy subject matter expertise and guidance regarding benefit design/redesign to ensure efficient pharmacy and medical benefit drug spend.

f. Collaborate across the health services division in the integration of pharmacy with other health services initiatives.

g. Lead and manage collaboration with the Sales team to support the renewal, RFP, and new sales customer activities. Provide consultation to ensure appropriate pharmacy and medical drug benefit strategies are recommended, presented, and implemented.

h. Deliver presentations to major current customers and potential large group clients. Serve as pharmacy resource to marketing for customer presentations and publications.

i. Develop, maintain, and strategically leverage strong rapport with external relationships such as PBM, local pharmacy associations, provider groups, employer groups and brokers. Ensure market competitive PBM and Specialty Pharmacy results while focusing on developing long- term value for customers through clinical pharmacy program innovation. Provide leadership and oversight of relationships with legislative and regulatory bodies.

j. Establish and manage the annual pharmacy budget to meet and exceed operational goals and key performance indicators.

k. Build, inspire, and engage a high-performance team that is member and customer centric.

l. Other duties as assigned.

This job requires a non-compete agreement.

An Equal Opportunity Employer

The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.

Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at