Principal, Formulary Consulting

About this role

Exemption Status: United States of America (Exempt)

$114,622 - $160,472 - $206,321 “Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description Summary

The Principal, Formulary Consultant, promotes the vision, goals, strategies, and objectives of the Trade Relations department in accordance with overall company goals and objectives. Strategically and tactically enhances the pharmaceutical rebate program and corporate revenues by identifying and capitalizing on opportunities to enhance rebate yields through greater formulary compliance, synchronizing formulary and rebate contract alignment opportunities, driving preferred product market share, leading formulary strategy, and coordinating with Pharmaceutical Manufacturers on programs that encourage shifts in utilization in alignment with formulary designs.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Proactively identifies, develops, and executes initiatives which optimize rebate yields and administrative fee revenue through an array of channels and processes, which includes developing and delivering value proposition statements (financial and clinical) with respect to rebate and formulary alignment opportunities to internal and external stakeholders who are responsible for formulary placement decisions.  • Works independently and in collaboration with Pharmaceutical Manufacturers and rebate vendors in order to develop and implement processes, products, and methods which support rapid utilization conversions following formulary placement changes to quickly optimize rebate production.  

• Serves as an internal and external subject matter expert to the company and client plans related to contractual rebate terms, conditions, requirements, interpretation, compliance and overall rebate strategies; individually responsible for direct communications and relationships with high profile and strategic clients to educate, inform, recommend and persuade these clients to adopt changes that drive rebate yields.  • Communicates tactical solutions to optimize rebate yield and reduce drug spend through a combination of formulary management techniques and pull-through initiatives to stakeholders throughout the enterprise (including Formulary Services and Drug Information) as well as to rebate clients in coordination with Account Management teams.   • Responsible for rebate, net spend, and disruption modeling using direct and external rebate contract terms and client utilization, and for presentation of modeling results and recommendations to clients and account teams. Responsible for rebate performance and trending analysis for internal and externally sourced rebates and administrative fees.  • Develops strategic and tactical solutions in coordination with the Director, Industry Relations and with the Formulary Business Review Committee to optimize rebate yield and reduce drug spend through a combination of contract design and coordinated execution of formulary management and clinical / utilization edits for all lines of business (Commercial, Medicare, Medicaid, Health Exchange).  • Develops strategic and operational solutions for Risk Based Contracting and other innovative contracting initiatives in support of emerging rebate propositions.   • Manages “Formulary and Rebate Optimization” staff to achieve established unit and company goals and objectives.    • Collaborates with Rebate Operations management to evaluate of contract rebate eligibility qualifications with respect to each individual client plan for purposes of rebate qualification and calculation, supporting quality assurance efforts to ensure accurate rebate billing, collaborating with account management teams to support rebate initiatives, and other activities supporting the contracting strategy, implementation and performance.   • Supports other departments throughout the company through establishment and cultivation of opportunities related to Pharma supported initiatives such as Medical Management coordination, aligning Patient Care Center initiatives, executive business briefings, communication and coordination of LDD distribution channels, member support programs involving Centers of excellence, pharmacoeconomic analysis projects, etc.  • Actively participates in the formulary strategy development process with respect to formulary management opportunities that improve rebate yield and drive lower net costs for clients for MedImpact Standard formularies operating under direct and indirect rebate agreements. Participates in the Formulary Business Review Committee with the responsibility to generate recommendations for consideration by the committee with respect to MedImpact Standard Formulary changes

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