Dir Account Operations - Louisiana

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.

Dir Account Operations - Louisiana

The Director Account Operations - Louisiana is accountable for the overall success of the account including financials, operations, and overall performance. This role will lead a team to develop and execute account plans including retention and growth strategies. The role is responsible for monitoring specific account contracts to ensure performance complies with service levels and performance standards, internal policies, and state and federal regulations. This role will serve as a single point of contact for the state and all Managed Care Organizations (MCOs) to build strong relationships and drive partnership on operational efficiency, financial success, and customer satisfaction for the account.

Responsibilities

• Lead a team responsible for account success and all day to day activities by driving operational excellence, issue resolution, and execution of all day to day and maintenance activities to meet all performance measures and exceed client and member expectations.
• Develop strong relationships internally and externally to meet customer service requirements, including attainment of performance guarantees, minimization of expense and reporting of performance measures including drug claims processing
• Create and maintain strategic partnerships with customers through the development and implementation of annual account work plans, retention and growth plans that result in long term retention and achievement of client goals; proactively presenting plans to clients annually.
• Serve as single point of contact for the state and MCOs including participation in state, provider, or enrollee meetings, appeal and grievance meetings, or state fair hearings.
• Resolve or appropriately escalate client or customer service issues and create processes and plans to mitigate future risk.
• Lead coordinated efforts across the organization to implement new program or process changes for the client. Manage change control process with the company's IT, Operations, Compliance, and other key Departments.
• Accountable for the management and accuracy of operations manuals, best practices and account procedures that incorporate proper payment rates and any updates to review procedures, submit to client for approval twice yearly.
• Manage budget, staffing, performance and development, and consistently demonstrate Prime's leadership expectations during interactions with direct reports, cross functional and external stakeholders.
• Fulfill the contract Chief Operational Officer role as a full time dedicated, Louisiana located team member.
• Other duties as assigned

Minimum Qualifications

• Bachelor's degree in Finance, Business, Health Care Administration or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
• MBA, MHA, MPA, or other advanced business degree or comparable work experience
• 8 years of account management, project management, or consultative experience within healthcare, PBM, Medicaid or other highly regulated industry
• 5 years of people management experience
• 2+ years of program or project management experience
• 3+ years of experience managing PBM program activities for a state Medicaid program with large population equal or greater than Louisiana Medicaid Program
• Have demonstrated experience in PBM system operations and experience developing and managing a pharmacy network.
• Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

• Ability to establish trust, respect and credibility and form close working relationships with all levels of customers
• Demonstrated ability to distill complex concepts or situations into concise and compelling communications
• Strong negotiation and influencing skills
• Exceptional client relationship management and cross-functional team building skills
• Critical thinking skills and ability to anticipate issues and develop innovative solutions
• Proficient with Microsoft Office (Excel, Access, Word, PowerPoint)

Minimum Physical Job Requirements

• Ability to travel up to 20% of the time
• Constantly required to sit, use hands to handle or feel, talk and hear
• Frequently required to reach with hands and arms
• Occasionally required to stand, walk and stoop, kneel, and crouch
• Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Reporting Structure

• Reports to Sr Director, AVP or VP in Account Leadership

Potential pay for this position ranges from $109,000.00 - $174,000.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected class under federal, state, or local law.

Positions will be posted for a minimum of five consecutive workdays.