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Pharmacy Services Part D Director (Medicare Stars) - 240499

DESCRIPTION/RESPONSIBILITIES: The Pharmacy Services Part D Director is responsible for developing and managing the strategy to optimize Part D Stars Rating. The Director will play a critical role in driving improvement in Medicare Part D Stars measures. Specifically, in analyzing data, identifying improvement opportunities, and working in conjunction with cross-functional teams with the goal to improve performance.

Key Responsibilities: * Lead the development and execution of program initiatives to improve our Part D Stars measures including Clinical, PBM managed, and consumer experience. * Develop and implement actions plans and collaborate with key stakeholders to ensure measures strategy is clear and well-defined with specific goals to achieving desired results. * Responsible to develop a tangible operational work plan and calendar of initiatives as well as dive into root cause analyses to address and remove barriers to success. The Director will work collaboratively with cross-functional teams to utilize analytics to understand pharmacy cost drivers, identify opportunities to positively impact costs and lead the team in establishing innovative new programs, partnerships, and payment models in the Part D space. Cross-functional teams include Government Markets (Stars, Product, Sales, Marketing), Clinical, Risk Adjustment, Actuarial, and Facilitated Health Networks. * Identify gaps and generate areas for improvement across various measures. * Collaborate with internal Part D matrix colleagues to help develop overarching Part D strategy, providing thought leadership, strategic insights on product development, pricing/bids, formulary analysis, regulatory change impact analysis, Star performance, membership growth/mix impact and profitability. * Provide early leadership to move approved ideas into execution. As the early driver of execution of approved products and capabilities, begins the execution of business plans and creatively solves product design, financial, and administrative challenges. * Provide oversight and accountability for delivery of compelling business cases to secure prioritization and support of products and capabilities. * Collaborate with Government Markets to provide strategic competitive analysis to ensure appropriate positioning for our product portfolio across multiple regions. * Serve as the subject matter expert and provide recommendations designed to address Medicare Stars ratings to other important Star measures such as HEDIS, CAHPS, etc. * Support Product Development:  ideation around new product and service concepts, product strategy, priorities, and product roadmap, including tiering structure, formulary inclusion decisions, balancing those with member experience. * Establish strong, strategic PBM relationship, including support to the P&L in the development of a multi-year, Medicare Advantage-specific, road map to ensure cohesive alignment with a critical business partner. * Develop an excellent network within the organization and have strong relationship building skills. Passion and energy for driving and supporting change as well as the ability to lead multiple and varied initiatives simultaneously will be key. * Maintain strong knowledge of industry trends, regulations, and guidelines.

Qualifications: * Bachelor's Degree in Business, Health Care Administration, or related field. Master's Degree preferred. * Minimum 10 years' experience in pharmacy benefit management, managed care, or Part D actuarial/consulting, including a minimum 2-3 years for Part D related Stars management. * Demonstrated mastery of Medicare Part D is required. * Healthcare industry and strategy development experience highly preferred. * Extensive experience in project planning and scheduling, budget management and risk mitigation. * Ability to collect, interpret, and draw conclusions from complex data. * Proven ability to manage mu tiple priorities and deadlines in a fast-paced environment. * Working knowledge of Medicare Part D benefit design. * Strong communication and interpersonal skills with the ability to build strong relationships with internal and external stakeholders. * Demonstrated track record as an effective collaborator with the ability to influence others and gain consensus. * Strategic thinking and problem-solving abilities to identify and address challenges proactively. * Strong leadership skills and attention to detail

Independence has implemented a "Hybrid" model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the "Hybrid" model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania

Equal Employment Opportunity Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.