Health Care Manager-Pharmacy

<p><strong>With more than 8,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust. Interested in joining us?</strong></p>

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="https://www.bcbsm.com/" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="http://www.bcbsm.com/index/about-us/our-company.html" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />Learn more about your options as an external candidate. <a href="https://bcbsm.taleo.net/careersection/2/jobsearch.ftl?lang=en" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions.&nbsp; http://www.bcbsm.com

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Full-time

Competitive Total Compensation Package

Overview: <p>Responsible for researching, planning, organizing, directing, implementing, and management of corporate programs and initiatives dedicated to enhancing health care value. Position operates within broad objectives to ensure optimum utilization of manpower and budget. Specialize in research, planning, development, implementation and leadership.</p>
Responsibilities: <ul> <li>Utilize data analytics and extensive business knowledge to manage the research, analysis, identification and evaluation of data from identified problems to evaluate existing and potential trends, competition, and issues.&nbsp;</li> <li>Possess and maintain in-depth knowledge of BCBSM business, products, programs (including claims, reimbursement, benefits, provider and program data, networks, etc.), corporate organizational structure (including functional responsibilities), and complex research principles/methodologies.&nbsp;</li> <li>Lead and monitor multidisciplinary corporate programs/projects simultaneously by managing the establishment of project plans and objectives to ensure goal attainment within defined parameters. Develop solutions to complex issues and present recommendations to senior management as well as employees at various corporate levels.&nbsp;</li> <li>Act as a Health Care Consultant by developing strategies and programs to reduce health care benefit costs and improve quality of care.&nbsp;</li> <li>Collaborate with appropriate business areas to implement proposed solutions and manage programs to evaluate effectiveness and results<em>.</em>&nbsp;</li> <li>Ensure programs and initiatives encompass broad corporate scope and present significant variables.&nbsp;</li> <li>Anticipate, identify, and resolve challenges in order to fulfill key corporate objectives and respond to the demand of change management and initiate actions needed to plan, organize and control team activities.&nbsp;</li> <li>Independently develop and plan, reports, papers and/or other materials.&nbsp;</li> <li>May have direct supervisory responsibility which includes performance reviews.&nbsp;</li> <li>Other duties may be assigned.</li> </ul> <p><u>Departmental Summary:</u></p> <ul> <li>Responsible for the coordination, facilitation and implementation of Pharmacy Services programs based on business needs and regulatory/legislative mandate requirements.</li> <li>Supporting mandate implementation, qualified health plan certification, certificate updates and communications</li> <li>Pharmacy program Implementation, facilitation and oversight</li> <li>Managing medication reconciliation program efforts related to data enablement and facilitating future innovations around the use of medication reconciliation data</li> <li>Identifying new pharmacy program opportunities</li> <li>Tracking and reporting progress of program outcomes</li> <li>Coordination with internal and external stakeholders for program implementation</li> <li>Support electronic prescribing efforts through collaboration with pharmacy benefit manager and Value Partnerships</li> <li>Support efforts to provide medication pricing to providers at the point of prescribing in their electronic health records</li> </ul>
Requirements: <ul> <li>Bachelor's Degree in Business Administration, Economics, Health Care, Information Systems, Statistics or other related field is required. Master's Degree in related field preferred.</li> <li>Seven (7) to Ten (10) years experience of related experience, typically in two (2) subject areas (e.g. financial analysis, planning, health care economics, health care policy, statistical modeling, business decisions, analysis, or business management).</li> <li>Excellent analytical, planning, problem solving, verbal and written skills to communicate complex ideas.</li> <li>Excellent knowledge and use of existing software packages (PowerPoint, Excel, Word, etc.).</li> <li>Ability to work independently, within a team environment and communicate effectively with employees at all levels.</li> <li>Other related skills and/or abilities may be required to perform this job.</li> </ul>