TriWest Healthcare Alliance

Pharmacy Program Manager (Provider Services)

Recruiting Location Phoenix, AZ
ID 2020-3023

Overview

Job Summary

 

 

The Pharmacy Program Manager is responsible for managing the operational relationship between TriWest and its dental subcontractor. The Program Manager will help to facilitate direction regarding network, communication, provider education and training, clinical quality, file exchange requirements (e.g. provider or eligibility files), claims integration and reporting. The Program Manager may assist with ensuring that the subcontractor fully understands and meets program requirements.

 

 

 

Responsibilities

Key Responsibilities

 

• Serves as one of the key points of contact to address program implementation issues, network management, provider education and communication needs and system integration

• Manages relationship with the primary subcontractor related to network management and all related work streams (e.g. provider education)

• Collaborates, and coordinates support the subcontractor may need such as program education materials

• Determines the impact of government contract requirements and specific business initiatives on operations and communicates those impacts to primary subcontractors stakeholders

• Identifies and communicates opportunities for redefinition of operational and management processes based upon analyses of “lessons learned” in order to improve operations effectiveness and efficiency

• Creates, manages and executes action plans, developed in conjunction with the primary subcontractor, to improve operations and adherence to contract standards

• Communicates operational changes and training and program materials to primary subcontractor stakeholders for distribution to staff

• Assists with special projects and other duties, as assigned by TriWest Senior Leadership

 

Qualifications

Education & Experience

 

Required:

• Bachelor's degree in Business Administration, Finance or Health Care Administration or similar degree; OR equivalent experience

• 3+ years related experience to include pharmacy program management experience to include contracting or network management

• Proven ability to execute across multiple locations and stakeholder groups

• Experience working on and influencing teams to produce desired outcomes

• Experience with data analysis, statistical analysis, process flow mapping and report design, including proficiency with database querying and the Microsoft Product Suite (specifically Word, Excel, PowerPoint, Project, and VISIO)

 

Preferred:

• MBA • Experience with quality programs (Six Sigma, Total Quality Management, Continuous Quality Improvement or other quality concepts)

 

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