Description Develop, implement, and improve analytical models, protocols and processes to support contract compliance and optimization for Kroger Prescription Plans (KPP) and its clients. Identify opportunities and create strategies to enhance rebate performance, improve clinical outcomes and decrease costs. Responsible for utilizing understanding of health plans and PBMs to provide insights to the clinical and account management teams that drive business growth and reduce problematic trends for KPP clients. Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion and safety.
Responsibilities - Partner with the Director of Clinical Services & Operations and SVP, Kroger Prescription Plans in the negotiation strategies with market access functions of branded pharmaceutical manufacturers - Provide data and data supported recommendations that contribute to the development of formulary management strategies including recommendations for utilization management and/or strategic placement of existing/new drugs on the formulary to maximize benefits based on market trends - Perform analysis to assess value of formulary recommendations to ensure rebates are market competitive to achieve new client growth and margin retention - Manage/oversee all analytical reporting using comprehensive, standard methodologies to produce the desired output - Create a library of standard reports; maintain organized files/drafts in operationally designated locations - Provide budget impact models for high interest/impact medications to clients - Provide detailed analyses identifying KPP risks/opportunities, make recommendations for improvement - Provide ad-hoc, consultative analyses to internal/external clients - Deliver account management support evaluating client performance and compare forecasts with actuals - Utilize industry, competitive, client, and rebate knowledge to creatively problem solve and formulate rebate strategies that will offer market leading rates - Participate and support audit processes as a clinical/rebate subject matter expert; provides necessary information, documentation and analysis required by audits; support departmental and corporate development of audit support infrastructure - Must be able to perform the essential job functions of this position with or without reasonable accommodation
Qualifications Minimum - Other Bachelor of Science Degree in Pharmacy and/or Doctor of Pharmacy Degree (Pharm.D.) from an accredited U.S. School of Pharmacy - 2+ years of managed care experience - Pharmacist License - Advanced financial modeling and analysis capabilities - In-depth knowledge of PBM or healthcare informatics - Strong understanding of industry/technical terms, trends, and processes - Advanced proficiency in Microsoft Office - Ability to collaborate and work cooperatively in a team-based environment - Strong project management skills with the ability to effectively meet deadlines - Self-directed, ability to execute projects with minimal supervision - Excellent administrative, communication, and organizational skill with high attention to detail - Ability to quickly grasp complex issues and develop viable solutions
Desired - Any experience in pharmacy benefit management (PBM) and retail pharmacy management - Any PBM pricing and analytics experience
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