Pharmacy Performance Manager

Company Description

Why Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today! 

Learn more about our unique benefit offerings here. 

Job Description

Join our growing Pharmacy team and use your strengths at Wellmark! 

About the role: As a Pharmacy Performance Manager, you will manage the effectiveness of business process, performance, and key partnerships pertaining to Wellmark’s pharmacy line of business, including strong relationships primarily pertaining to Wellmark’s Pharmacy Benefit Manager (PBM) partner. You will monitor and ensure delivery of service level agreements (SLAs), cost-saving initiatives and contract compliance. You will do this by analyzing data points and trends through multiple sources and identifying criteria to build out dashboards and processes to monitor performance. You will work closely with internal stakeholders (clinical, procurement, member experience, etc.) as well as external stakeholders to help guarantee the pharmacy benefits program aligns with Wellmark’s overall corporate strategy. You will be uniquely situated as the “go-to” for pharmacy performance inquiries and will tap into resources and market trends to guide recommendations and decisions.  

About you: You are intellectually curious and highly analytical in your ability to dig into data and resources to find answers. You enjoy developing processes and tactfully making recommendations on areas for improvement. You are an effective communicator, both verbally and in writing, and are able to influence others in a collaborative manner by tailoring messaging to the audience. Building trust and relationships with stakeholders will be key to successfully making an impact. You are a resourceful self-starter who picks things up quickly, always jumping to learn something new and improve upon it. Time management is crucial, with the ability to simultaneously assess competing priorities, analyze the broader impact of escalations, and make informed decisions. You enjoy working in an environment that isn't always defined and can vary each day - working 'in the gray' is exciting to you! 

This position will work a hybrid schedule of at least 3 days (Tuesday, Wednesday, Thursday) in a Wellmark office, with 2 days (Monday, Friday) remote option. 

Qualifications

Preferred Qualifications - Great to have:

• Strong knowledge of PBM operations, pharmacy benefits design, etc.
• Experience working with PBM statistical systems.

Required Qualifications - Must have:

• Bachelor’s degree in healthcare administration, business, or related field, or applicable experience.
• Minimum of 5 years of experience in health insurance or related field.
• 2-3 years of experience with vendor relationships and performance monitoring with understanding of contracts.
• Strong business intuition and natural curiosity with strong abilities to communicate actionable insights to support business decisions.
• Excellent analytical skills with the ability to interpret complex data and to identify issues or inconsistencies, research root cause and identify alternative solutions.
• Strong financial understanding pertaining to invoices/billings, etc.
• Strong organizational and process improvement skills to facilitate and manage the implementation of process improvements.
• Effective consultation skills with the ability to provide recommendations, influence others to action, and solicit collaboration. Viewed as a subject matter expert and go-to resource.
• Strong communication and interpersonal skills, with the ability to present data clearly and succinctly to various audiences, including up to senior leadership.
• Self-starter with strong organizational skills and the ability to multi-task priorities. Ability to prioritize initiatives, align appropriate resources, and motivate teams to achieve success. Flexible and adaptable to change.
• Knowledge of healthcare regulations and compliance requirements including Centers for Medicare & Medicaid Services (CMS), HIPAA, ACA, etc.
• Proficient in Microsoft Office suite and has the technical aptitude to learn new systems and software quickly (PowerBI, Visio, PBM statistical systems, etc.).

Additional Information

What you will d