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Director, Payor Access and Clinical Operations

Company: Shields Health Solutions
Location: Ashland
Posted on: January 16, 2022

Job Description:

One of the fastest growing companies in America, Shields Health Solutions partners with hospital leaders on every aspect of specialty pharmacy creation and management. The company provides the fastest, lowest risk model for Hospital leaders to create a hospital-owned specialty pharmacy business, whether starting from scratch or adding specialty capabilities to a hospital's existing pharmacy programs.
General description:The Company is seeking a highly motivated, self-starter who is looking for a challenging career with a fast-growing company in the Healthcare Services sector. Applicant should be results-oriented with a positive outlook, and a clear focus on high quality. A natural forward-planner who critically assesses own performance. Mature, credible, well- presented, professional and comfortable in dealing with others both in-person and on the phone. Critical to this position is a person who is able to work well under deadlines and time pressures. Applicant must be reliable, tolerant, and determined; an empathetic communicator, able to see things from the other person's point of view. Most importantly, person must be able to work as a member of a close-knit team.
Job Purpose:The Director of Payor Access and Clinical Operations is responsible for establishing and maintaining specialty pharmacy payor contracts, supporting the development of clinical protocols and workflows related to PBM requirements, and supporting strategic payor initiatives on behalf of each partnering health system.Specific skills/qualifications:Strong leadership and people management skills, ability to analyze data/information to make sound business decisions, exercises good judgment, possesses strong written and verbal communication skills, able to manage and improve processes, exhibits strong technical and clinical skills
Required: 7+ years of pharmacy experience, 2+ years of operations experience, active pharmacy license in good standingPreferred: Specialty pharmacy experience, CSP certification, Pharmacy Benefit Management knowledgeTraits: Organized, high-integrity, self-motivated, highly productive, quality focused, attention to detail, empathetic, good listener/communicatorOther: Energetic, highly motivated, team player, extreme discretion and confidentiality are essential as this position deals with highly sensitive and private data
Job Duties:

  • Source specialty pharmacy and retail pharmacy payor contracts on behalf of each partnering health system
  • Evaluate clinical, training and reporting requirements outlined in contracts, evaluate compared to existing infrastructure, and support internal and external teams in gap resolution as needed
  • Work closely with legal, business, and clinical teams to ensure contract language accurately conveys intent
  • Participate in the strategic development and implementation of payor strategies
  • Lead the development of new processes and works to continuously improve pharmacy's operations to ensure the best patient service as well as successfully delivering commitments to hospital partners
  • Identify trends, resolve problems; drive enhancements and efficiencies; effective and timely implementation of change initiatives
  • Establish strong and credible relationships with our partners and clients, demonstrating a commitment to customer service
  • Update job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations
  • Willingness to do whatever is necessary for the betterment of the Company
  • Other duties as assigned

Keywords: Shields Health Solutions, Boston , Director, Payor Access and Clinical Operations, Executive , Ashland, Massachusetts

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