VP Network Contracting - Genoa Healthcare - Eagan, MN
- Eagan, MN
Opportunities with Genoa Healthcare. A career with Genoa Healthcare means you're part of a collaborative effort to serve behavioral health and addiction treatment communities. We do more than just provide medicine: we change lives for the better. People with serious mental or chronic illness - and those who care for them - have moving stories, and at Genoa we become their voice, their partner. Working as part of a coordinated care team, we partner with community-based providers and others to ensure that people with complex health conditions get the right medications and are able to follow their treatment plans. Our personalized services - in-clinic pharmacies, telepsychiatry and medication management - are leading the way to a new level of care.
We recently joined OptumRx, a pharmacy care services company that is part of Optum and UnitedHealth Group's family of businesses. We are part of a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Take a closer look to learn why a career with Genoa Healthcare might be the path to discovering your life's best work. SM
Reporting to the Senior Vice President, Procurement & Network Management, this position provides oversight and management for pharmacy and medical claims contracting, network management and performance measurement, pharmacy licensing and payer audit activities for all lines of business nationally at Genoa. Reporting to this role will be the contracting and network management functions for both pharmacy and medical claims, pharmacy licensing and audit personnel and supporting data analysts. In addition, this person will assist in building out the organizational design to support the rapid growth of our business.
Major Duties & Responsibilities:
- Own relationships with PBMs and payers to ensure pharmacy and medical contracts and networks are effective and up to date to support the national network of Genoa pharmacies.
- Develop and lead overall payer contracting strategy and execution including negotiations, contract management, and profitability targets.
- Establish overall contracting and network servicing function and capability.
- Execute national approach to establish Genoa as industry leading pharmacy chain dedicated to serving the needs of behavioral health and complex populations.
- Build out contracting and network team to increase capability of existing functions and add new roles to support future strategy and growth of the company.
- Educate payers and develop the company's brand and identity to support the mission of a growing, customer-focused company.
- Keep abreast of state and federal government legislation as well as market dynamics to anticipate industry and payer trends.
- Collaborate with operations leadership to establish and execute contracting strategies and objectives, identifying and prioritizing areas of focus.
Educational or Skills Requirements:
- Undergraduate degree is required.
- Advanced degree, Pharm.D. or MBA is highly desirable.
- 10+ years total professional experience, with significant experience working for a large national payer.
- 5-7 years managerial experience building and leading teams.
- Experience developing relationships with payer leaders; network of payer relationships at the highest level that can be leveraged.
- 5+ years of progressive experience within Medicare Advantage, Medicare Part D and Managed Medicaid reimbursement.
- Demonstrated experience in pharmacy network operations involving claims administration, contract administration, policy and procedure development and contract servicing.
- Experience in negotiating contracts and interfacing with PBMs
- Experience in contract design and dealing with the regulatory complexities of contract language.
- Experience developing and contributing to the growth of a business.
- A change agent, transformational leader and game changer within an organization.
- Strong managerial skill set. Ability to clarify roles & responsibilities within an organization and hire excellent talent.
- Strong knowledge of payer benefit strategies and trends.
- Pharmacy network contracting/program development.
- Highly developed relationship-building skills to foster effective working relationships across Genoa.
Desired Competencies, Skills and Attributes:
The candidate will have achieved his/her past success thorough the demonstration of several critical behavioral competencies.
Results Orientation - He/She has demonstrated the ability to achieve functional and company results that surpass expectations across multiple periods of time within one organization. This executive will have an innate thirst to drive for results that over-index against key performance benchmarks within the industry. He/She will be creative, scrappy and resourceful in a smaller, high growth company with limited resources. The candidate will have imported or created new solutions, business opportunities, or processes that have a measurable impact to firm value and market share.
Strategic Orientation - He/She will have the intellectual capacity to discern complex perspectives within competing or new markets to create a compelling, coherent strategy that positions the firm to win beyond its short-term goals. They will have designed and implemented innovative strategies, perhaps beyond their own area of responsibility that moved a company into broader and/or an entrenched leadership role within their industry.
Collaboration - He/She understands how to effectively influence and collaborate horizontally and vertically to achieve consensus and alignment that supports the actions and goals of the management team. The executive will have demonstrated how they build trust vertically and horizontally and have used influencing styles (direct and indirect) to create successful solutions that were broadly adopted.
- The intelligence, motivation, and passion to build a world-class company and deliver value to shareholders and customers.
- The ability to be an operator, steward, strategist, and catalyst.
- Exceptional ability for analytical and strategic thinking.
- A "partner" mindset, facilitating close work with the management team in developing strategy.
- Strong entrepreneurial drive, high energy, a "self-starter" attitude, the ability to set and meet aggressive goals, and the drive to succeed both personally and professionally.
- A commanding presence, excellent written and oral communication skills, and superior presentation abilities to be a credible internal and external spokesperson.
- The ability to communicate a vision and lead others to execute it.
- The clarity of vision and strength of conviction to act decisively and authoritatively, without consensus when necessary.
- The ability to hold others accountable and to proactively address and resolve conflict.
- The ability to create a culture of shared values in which employees work cooperatively toward common and mutually recognized objectives.
- Experience with market uncertainties and the ability to weather a storm and maintain equanimity during short-term market fluctuations.
Please go to the website to apply.
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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