Manager Rx Compliance & Third Party Contracting

Looking for a company that treats associates with respect, understanding, and appreciation? Looking for a company that is passionate about teamwork and the growth of it's associates and communities? That's WEIS!

Job Description:

ESSENTIAL DUTIES AND RESPONSIBILITIES

The associate is responsible for the functions below, in addition to other duties as assigned:

• Monitor, interpret, and implement changes within the department and organization to maintain compliance with federal and state pharmacy laws, regulations, and standards.
• Develop and maintain compliance-related policies, procedures, and training programs.
• Ensures adherence is being maintained with all Board of Pharmacy requirements regarding pharmacy operations, licensure, and pharmacy construction activities.
• Manage negotiations and renewals with third-party payers for Medicare, Medicaid and Commercial plans.
• Analyze reimbursement and plan performance metrics to evaluate contract values and financial impacts.
• Assist in responding to inquiries from third-party auditors, State Boards of Pharmacy, or federal agencies.
• Design, implement, and oversee the Pharmacy Quality Assurance Program to promote patient safety and regulatory compliance.
• Leads regular evaluations of the Quality Assurance Program to analyze trends and explore root causes opportunities for improvements.
• Collaborate with pharmacy leadership to develop and implement plans, strategies, and processes. Explores points of integration and synergies with current pharmacy systems.
• Works to support government affairs and relations activities with state organizations.
• Responsible for ensuring new hire training programs and ongoing yearly training meet state requirements and third-party expectations.
• Assists in maintaining compliance with all controlled substance reporting and monitoring requirements.
• Develop and maintain a series of reports used to evaluate the performance of key objectives for the pharmacy department in relation to compliance, third-party results, and quality assurance events.
• Maintains and evaluates in store HIPAA and Operations compliance audits.
• Assist in processes to ensure timely credentialing and payer communications.  
• Maintains a working knowledge of all information systems used by the pharmacy teams.
• Partner with information technology, human resources, store operations, legal, and finance departments to ensure aligned execution of pharmacy programs.
• Prioritize pharmacy tasks and follow through to ensure all work is completed in a timely manner.  

Qualification Requirements

To perform this job successfully, the associate must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required:

Education and/or Experience

Doctoral degree (PHARM.D.) or equivalent in Pharmacy, plus seven (3) years' experience in retail pharmacy with at least three (3) years’ experience with pharmacy compliance or contracting or equivalent combination of education and experience.  In addition, working knowledge of pharmacy systems is helpful.

Active license as a practicing pharmacist.

Language Skills

Ability to read, analyze, and interpret common scientific and professional journals, financial reports, governmental regulations, and legal documents. Ability to respond to inquiries or complaints from customer, regulatory agencies, or members of the business community. Ability to write speeches and articles for publication that conform to prescribed style and format. Ability to effectively present information to top management, public groups, and/or boards of directors. Ability to read, write, and speak English fluently.

Mathematical Skills

Ability to work with mathematical concepts, such as probability and statistical inference, and fundamentals of budgeting. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

Reasoning Ability

Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems. Ability to deal with nonverbal symbolism (formulas, scientific equations, graphs, etc.) in its most difficult phases. Ability to deal with a variety of abstract and concrete variables.

Certificates, Licenses, and/or Registrations

This position requires the following Licenses and Certifications:

·         Valid driver’s license for business travel purposes.

·         Valid Pharmacist Licenses in all states practicing pharmacy.

·         Valid Immunization Certification.

·         Valid Immunization License in the state practicing pharmacy, if required by state regulations.

Weis Markets is an Equal Opportunity Employer:  Weis Markets is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of actual or perceived age, sex, sexual orientation, race, color, creed, religion, familial status, ethnicity, national origin, citizenship, disability, marital status, military or veteran status, or any other legally recognized protected basis under federal, state or local laws, regulations or ordinances. Applicants with a disability may be entitled to a reasonable accommodation under terms of the Americans with Disabilities Act and certain state or local laws. A reasonable accommodation is a change in the ways things are normally done which will ensure an equal employment opportunity without imposing undue hardship on Weis Markets.