Capital Rx is an enterprise health technology company providing comprehensive solutions for employers and health plans. The Market Access Programs Senior Project Manager will lead the development and execution of innovative market access programs, collaborating with internal teams and external partners to enhance member experience and reduce drug spend.
Responsibilities:
- Collaborate with key stakeholders to develop and maintain new and existing market access programs for all relevant lines of business. Programs include, but are not limited to, innovative pharmacy network configurations and partnerships with supply chain stakeholders
- Engage with appropriate stakeholders and cross-functional teams to ensure successful implementation and execution of programs
- Regularly update and maintain comprehensive implementation plans, workflow guides, trainings, rules sets, and other documentation as relevant and required
- Implement quality control processes to ensure program compliance with established standards and guidelines. Conduct and document audits and work with appropriate stakeholders to implement corrective actions as needed
- Own relationship with and provide oversight of third-party vendors and/or partners (pharmacy providers or manufacturers) to administer programs with emphasis on member experience and value capture for clients
- Use reporting tools and partner with our Analytics team to develop and maintain opportunity analyses and ongoing savings performance reporting
- Support the go-to-market strategy of program offerings including pricing, marketing, and implementation. Support RFI and RFP submissions
- Evaluate evolving industry and market landscape and analyze prescription claims data to identify opportunities for improving existing programs and developing new programs and/or partnerships. Supports quality improvement programs/projects as required
Requirements:
- Bachelor's Degree required
- 4+ years of experience applicable to health care, such as in a health plan, PBM, pharmacy, manufacturer, value-based care, or managed care environment; consulting, advising, or tech enablement focused on the preceding areas also considered applicable
- Ability to balance multiple complex projects simultaneously with minimal direction
- Great time-management and organizational skills to manage multiple active projects simultaneously
- Exceptional written, verbal, and presentation skills
- Experience working with data reporting tools, conducting data analyses, and effectively consuming/interpreting data reports and visualizations
- Master's Degree in relevant field (PharmD, MBA, MHA/MHP, etc.)
- Experience with prescription drug channels and payment workflows (pharmacy reimbursement, rebate administration and GPO relations, regulatory requirements, etc.)
- Experience with health insurance or health benefits administration (pharmacy benefits in particular)
- Strong experience in developing, implementing, and using data and workflow management technology solutions (e.g., customer relationship management (CRM), Jira/Salesforce, collaborative Excel workbooks in SharePoint, etc.)
- Experience with programming languages relevant to data analytics, such as SQL or Python
- Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and PowerPoint
- Ability to think strategically and identify inefficiencies, develop long-term solutions, and challenge and improve existing processes through automation and redesign
- Highly detail-oriented and analytical
- Ability to travel occasionally as needed for internal, client, and vendor/partner meetings