Staff Vice President, Specialty Pharmacy Clinical Operations
Elevance Health
Senior Project Manager, Medicare Medical Pharmacy
CVS Health
full-time
Posted on:
Origin: • 🇺🇸 United States • Idaho, Pennsylvania
Visit company websiteSalary
💰 $67,900 - $199,144 per year
Job Level
Senior
About the role
- Accountable for leading the implementation of business projects and programs and managing operations within the Medicare Part B Pharmacy Team
- Act as a Subject Matter Expert impacting processes, systems, products, and/or functions
- Oversee and problem-solve daily operations issues within Medicare Part B
- Lead the day-to-day operations of key business projects and programs around utilization management (UM), clinical programs, and pharmacy operations
- Proactively lead projects by setting direction, creating project plans, timelines, identifying key milestones, and allocating resources
- Support the submission of pharmacy policies through multiple approval bodies and support posting of pharmacy policies for internal and external partners and stakeholders
- Develop processes, procedures, and systems to ensure consistent results and organizational compliance with regulations related to the organization's Medicare Part B program operations
- Triage escalation requests to the correct internal partner and document resolution of Part B drug escalations
- Identify gaps and recommend enhancements related to new and/or existing products, services, and workflows
- Lead change initiatives and continuous quality improvement
- Conduct and lead meetings/presentations with cross-functional business partners and clearly communicate implementation plans to impacted parties
- Other duties as assigned
Requirements
- 5 years of experience leading processes, products, and/or people
- Experience managing complex processes that require strong attention to detail
- Experience partnering with cross functional teams; PBM or Health Plan experience preferred
- Proven ability to collaborate effectively across teams and build strong relationships
- Exceptional problem-solving and decision-making skills
- Growth mindset with a focus on agility, continuous learning, and development
- Proficient user of Excel, PowerPoint, Word
- Project management certification (preferred)
- Bachelor's degree preferred or a combination of equivalent work experience and education
