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St. Luke's Health System Pharmacy Business Manager in Boise, Idaho

Overview

St. Luke’s Health System in Boise is seeking a Manager of Pharmacy Business to join our Pharmacy Administration team.

This role dedicated to pharmacy and medical drug contracting, analysis, and strategy would be sufficient, for the time being, assuming they also had access to existing reporting and analytics resources. This rolewillsupport contract and payer relations for the pharmacy ensuring that contract requirements are appropriately met, contracts are kept up-to-date in the pharmacy paper records and electronic files.Work closely with retail, specialty, PBM, and home infusion pharmacy leaders to inform contracting related business processes as well as communicating the St. Luke’s value story to PBMs and third party payers.

Responsibilities

  • Work with information technology teams to develop a medical drug and pharmacy claims database and reporting infrastructure that provides timely data on drug level and payer specific reimbursement levels to inform contract negotiations and other strategic business decisions.

  • Assist in and support negotiations, in alignment with payer relations department, with third party payers for medical drug contract rates to ensure competitive, current, and profitable reimbursement levels. This includes preservation of St. Luke’s pharmacy distribution volume despite threats of drug carve outs.

  • Negotiate with Pharmacy Benefit Managers to ensure competitive reimbursement levels, including oversight of the Elevate contracting relationship and systematic monitoring of in-force contract rates by payer.

  • Conduct regular business reviews with pharmacy and payer relations leadership comparing drug level reimbursement rates, profitability analysis, and payer contract competitiveness in order to inform renegotiation opportunities and other pharmacy operations strategies.

  • Maintain a current medical and pharmacy drug fee schedule for high impact medications to inform contract negotiation and ensure profitability.

  • Advise pharmacy and payer relations leadership teams on drug distribution strategies based on contract rates and profitability analyses.

  • Maintain a current contract rate database for retail pharmacy reimbursement levels and high impact drugs reimbursed under the medical drug benefit.

  • Establish and maintain relationships with pharmacy leaders at major payer partners and PBMs relevant to St. Luke’s.

Qualifications

  • Education: Bachelor’s Degree required or 4 years equivalent experience in lieu of Bachelor’s Degree

  • Experience: 5 years’s experience, plus 3 years of supervisory and/or managerial experience.

  • Licenses/Certifications: None

Why St. Luke's

A strong, talented staff is at the heart of St. Luke’s Health System. We are the state’s largest employer with more than 15,000 employees and a medical staff of more than 1,800 physicians and advanced practice providers. We’re proud of our people who deliver skilled, compassionate care every day, and are looking to add dedicated individuals who will continue this same tradition of excellence.

*St. Luke’s is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law.

Category Pharmacy

Work Unit Pharmacy Administration System Office

Position Type Full-Time

Work Schedule DAY

Requisition ID 2021-46289

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