Job Details

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Company :

Highmark Inc.

Job Description :

JOB SUMMARY

Work with the Pharmacy Medicaid/DSNP Business Unit business owners, stakeholders, and management to achieve growth objectives. Organize and coordinate activities to focus on delivering results. Monitor progress and perform corrective actions as needed. Communicate regularly with customers regarding issues or concerns. Responsibilities include:

1. Research, manage, and lead projects to meet business objectives, analyzing data for process improvements.
2. Identify needs for new Pharmacy Medicaid/DSNP services or programs, researching and evaluating feasibility.
3. Ensure compliance with regulations, policies, and procedures, monitoring regulatory changes and industry trends.
4. Provide analytic support, developing models and forecasts to identify trends and risks, translating insights into strategies.
5. Collaborate with stakeholders to understand needs, define requirements, and develop business cases for applications and enhancements.

ESSENTIAL RESPONSIBILITIES

1. Implement product/program designs, ensuring quality, financial, and regulatory standards are met. Develop processes and measurement methods for continuous improvement.
2. Analyze data and business processes to support program oversight, designing solutions and making decisions to improve practices.
3. Work with multidisciplinary teams to ensure program effectiveness and manage projects.
4. Resolve escalated or complex issues.
5. Develop solutions to satisfy goals, conduct problem-solving sessions, and promote a culture of performance excellence.
6. Communicate effectively across organization levels, identifying and articulating problems to management.
7. Research and develop competitive pharmacy benefit offerings to optimize member experience and product viability.
8. Perform other duties as assigned.

Education

• Required: High school diploma / GED
• Preferred: Bachelor's Degree

Experience

• Required: Healthcare and project management experience
• Preferred: Project management certification

Skills

• Proficiency with MS Office
• Experience in presentations to diverse audiences
• Critical thinking and problem assessment skills
• Excellent communication skills

Other Details

Travel: 0-25%

Position: Office-based, with occasional travel and physical demands as described.

Pay Range: $57,700 - $107,800, based on qualifications and location.

Highmark Health is committed to diversity and accessibility. For accommodations, contact ...@highmarkhealth.org.