Strategic Director of Pharmacy Solutions

1 month ago

Mississauga, Ontario, Canada McKesson Full time

McKesson is a leading healthcare company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Our team focuses on the health, happiness, and well-being of our employees and those we serve – we care.

What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of a dynamic team that drives change, we want to hear from you.

Job Summary:

The Director of Pharmacy Strategy will oversee Biopharma's Payer programs and solutions. The incumbent is responsible for creating strategic partnerships by harnessing Payor insights and trends to develop best-in-class programs and leading the project execution and management of such programs with key clients in alignment with the Biopharma division's goals. The Director must have the ability to develop strong trusting client relationships with key Payors, including insurance carriers, third party administrators, benefit advisors and consultants, with a deep understanding of the drug and benefits landscape as well as private and public policy changes that impact business objectives. The Director will be responsible for the development of internal business cases, provide insights and recommendations, and be the primary lead for all external discussions, negotiations and implementation/execution of the program.

Key Responsibilities:

  1. Develop and implement best-in-class Payor programs and solutions to the insurance and benefits market, including Preferred Pharmacy Network/Prior Authorization/Case Management/Reimbursement/Manufacturer card programs.
  2. Plan and lead coordinated stakeholder strategies to engage and win clients.
  3. Manage the Specialty Pharmacy Kroll Central Maintenance team, the pharmacy adjudication/reporting system, Kroll.
  4. Conduct data analysis and provide insights on pharmacy specialty drug/program dispensing trends including pricing, billing, and revenue/margin trends.
  5. Strategically plan and direct pharmacy activities to reduce and mitigate claw backs from third party payer audits, documenting lessons learned and training pharmacies on best practices.
  6. Liaise with critical cross functional departments including PSP, INVIVA, Specialty Pharmacy, Provider Solutions, Finance, Technology, etc, to build and deliver Payor programs and ensure that business requirements are met.
  7. Develop financial profitability models to drive pricing and negotiation terms of new programs/solutions with clients including proformas and sensitivity analyses.
  8. Build and execute on short- and long-term strategic partnership roadmap for Biopharma & Provider solutions.
  9. Lead contract negotiations and execution with key stakeholders to optimize our participation in the PPN networks and other Payor Solutions.
  10. Accountable for program financial performance and oversee the budget for internal and external clinical resources, direct and optimize activities to drive results with efficiencies.
  11. Ensure Payor Programs are executed with excellence and operating efficiently, managing all issue resolution and escalations directly with clients.
  12. Drive thought leadership on the Payor Strategies and best practices through ongoing competitive market research to inform and optimize programs and solutions.
  13. Lead interactions within internal teams regarding PPN strategy and act as a subject matter expert in the payor space (solutions and strategies) for all McKesson teams.
  14. Lead identification of new business opportunities, business cases, and RFP responses for new opportunities in consultation with the business development team.
  15. Develop network of strong client relationships with key Payors, including influencers, securing business with key industry leaders within each stakeholder group.
  16. Lead relationship management activities and build product awareness with consultants and carriers and other partners as appropriate.
  17. Drive McKesson awareness and recognition in the Payor landscape and participate at key external meetings and events – conferences & presentations.

Requirements:

  1. Bachelors or Advanced degree in Business Administration, Pharmacy, or equivalent experience.
  2. 3+ years in P&L management.
  3. Experience with Payor, Health and Drug benefit programs including PPNs, PSPs, copay programs, case management and reimbursement programs.

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