Principal, PBM Operations Business Process Engineering

Your role in our mission

· Primary point of contact for the Pharmacy Clinical Operations organization, operational and process excellence management needs

· Conduct thorough assessments of existing business processes, identify bottlenecks, inefficiencies, and areas for optimization, then design, implement, and monitor process improvements.

· Optimize operational and technical business processes to enhance efficiency, reduce costs, and improve overall operational performance through continuous improvement, data analysis, and the implementation of best practices.

· Proactively identifies inefficiencies and implements process improvements

· Gathering and analyzing process-related data to identify trends, establish performance metrics to measure the impact of process changes, often using tools for tracking and reporting.

· Creating detailed process maps and flowcharts to visualize current workflows and design optimized future-state processes

· Collaborating with various departments and senior leaders to identify improvement opportunities, gain support for initiatives, and ensure alignment with organizational goals and strategy.

· Promotes a culture of continuous improvement, coaching and mentoring team members, provides training on process excellence concepts, tools, techniques.

· Prepares and delivers reports to executive leadership outlining progress towards goals and issue resolution across multiple areas of the organization.

· Remains current on new trends and best practice to incorporate into quality activities within the organization.

· Participates in the development and completion of Request for Proposals (RFPs) as required in reference to process flows.

· Identifies and prioritizes improvement projects to align with State Medicaid Agency operational and quality improvement requirements

· Ensures that member and provider perspectives are used to inform operational quality improvement projects and interventions and to assess the effectiveness thereof

What we're looking for

· Bachelor's degree or equivalent combination of education and experience

· Master's degree in business or technical field preferred

· Five or more years of experience in process management and quality improvement within managed care, or PBM pharmacy operations

· Five or more years of leadership or supervisory experience

· Experience working with operational systems and technologies

· Adept at applying and recommending quality improvement methodologies in pharmacy (ex. Lean, Six-Sigma, IHI’s Model for Improvement)

· Experience evaluating, operational benchmarking, quality metrics, and re-engineering operational and technical services.

Skills:

· Excellent verbal and written communication skills

· Demonstrated leadership ability to set vision, goals and create a positive culture

· Drives results through evaluation, analysis, and benchmarking of operational performance and quality metrics

· Leads across the organization through influence and collaboration

· Approachable and professional in all interactions

· Independently generate and deliver clear and concise executive level presentations

· Effective time management, be self-motivated, handle multiple tasks with accuracy

· Must be able to solve problems and make sound decisions without supervision

What you should expect in this role

· Work from home; reliable high-speed internet connectivity is required

· Occasional travel may be needed