Pbm Manager Jobs in Colorado (NOW HIRING)

US Telecommuter

Full time

R76557

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Vice President, Clinical Pharmacy

PRIMARY PURPOSE : To support the strategy and performance of Sedgwick's pharmacy program, serving as a client-facing pharmacy and clinical thought leader within Managed Care. Leveraging deep workers' compensation pharmacy expertise, this role supports the review and continuous improvement of the Sedgwick pharmacy program, translates claims and book-of-business data into actionable strategy, and partners directly with clients to represent pharmacy strategy and deliver value. The role represents Sedgwick as a recognized voice in the industry.

ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE:

• Provide senior, VP-level leadership across the pharmacy program, shaping strategy, direction, quality and performance.

• Bring deep workers' compensation pharmacy expertise across program strategy, design, clinical decision-making, and complex pharmacy management.

• Act as a client-facing leader, partnering directly with clients, representing pharmacy strategy in engagements, and translating program capabilities into client value.

• Own the review, refinement, and continuous improvement of pharmacy programs, elevating consistency, quality, defensibility, and outcomes.

• Provide analysis of claims data and book-of-business metrics, translating trends into actionable strategy.

• Serve as an external thought leader, representing the organization in industry forums and strengthening its market reputation.

• Partner cross-functionally with operational, clinical, and business leaders to align pharmacy strategy with organizational objectives.

• Works with pharmacy benefit managers on pricing models, reporting and specific program development such as the development of a pharmacy benefit network (PBN), new formularies and creating new and improved edits to custom triggers.

• Works with client services to create custom reporting for large clients; meets with clients to explain complexities of the program and demonstrate the benefits.

• Strategically supports our pharmacy benefit management vendor partnerships and the Sedgwick team who operationally support the product for clients.

• Prepares and delivers presentations for national conferences and client meetings.

• Stays ahead of the marketplace and assists client services in maintaining client relationships by clarifying offerings, value of products and defining real savings.

• Responsible for understanding the entire workers compensation pharmacy industry landscape and what that means to Sedgwick and clients.

• Works directly with clients and client services to develop solutions and discusses formularies and current pharmacy issues and trends in the industry.

• Responsible for determining the feasibility of bringing pharmacy benefit services as a Sedgwick offering; conducts research and determines if there is a business case.

• Delves into the details of pharmacy networks and pushes vendor partners to offer a transparent cost model with potential to have insight into rebates.

SUPERVISORY RESPONSIBILITIES

• Administers company personnel policies in all areas and follows company staffing standards and training recommendations.

• Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.

• Provides support, guidance, leadership and motivation to promote maximum performance.

QUALIFICATIONS

Education & Licensing

PharmD degree from an accredited university or school of pharmacy preferred or Bachelor's degree with commensurate experience in PBM management and health care benefit knowledge. Active unrestricted license to practice pharmacy as a PharmD or clinical pharmacist in at least one state in the United States preferred.

Experience

Ten (10) years of related experience or equivalent combination of education and experience required to include two (2) years of recent clinical practice experience and two (2) years of management experience. Workers' Compensation industry experience preferred.

Skills & Knowledge

• Knowledge of current pharmacy trends and alternative resources and treatments in out-patient and alternative care settings

• Substantial workers' compensation pharmacy background and command of the WC managed care landscape

• Demonstrated client-facing experience with senior stakeholders

• Strong analytical skills, with the ability to interpret claims and book-of-business data to inform strategy

• Track record of pharmacy program leadership, development, quality improvement, and innovation

• Recognized or emerging thought leader, comfortable representing an organization externally

• Executive-level presence, communication, and cross-functional leadership skills

• Understands how the brand drug rebate process works and if there is a potential to provide this back to clients

• Knowledge of utilization management

• Knowledge of workers' compensation

• Analytical and interpretive skills

• Proven management/leadership skills

• Excellent oral and written communication skills, including presentation skills

• PC literate, including Microsoft Office products

• Excellent interpersonal skills

• Ability to work in a team environment

• Ability to meet or exceed Performance Competencies

TAKING CARE OF YOU:

• Offering flexibility and autonomy.

• Supporting meaningful work that promotes critical thinking and problem solving.

• Providing on-going learning and professional growth opportunities.

• Promoting a strong team environment and a culture of support.

• Recognizing your successes and celebrating your achievements.

• We offer diverse and comprehensive benefits including medical, dental vision, 401K, PTO and more beginning your first day.

Work environment: When applicable and appropriate, consideration will be given to reasonable accommodation.

Physical: Computer keyboarding, travel as required

Auditory/visual: Hearing, vision and talking

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.

NEXT STEPS

If your application is selected to advance to the next round, a recruiter will be in touch.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $140,000 - $165,000/year. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com