Why Martins Point Generations Advantage
FY2024 · Form 990Its mission and biggest programs, as filedProvides essential services and support to those in need.
- Generations Advantage - Please see not-for-profit narrative statement for Martin's Point Generations Advantage on Schedule O.$777.4M spent in FY2024
Before you apply
FY2024 · Form 990Independent: from IRS data, not the orgAbout the role
The org's own posting, as writtenJoin Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.
Position Summary
The Vice President of Pharmacy Services provides strategic leadership and oversight for all pharmacy operations within the organization and for all bid related formularies/ strategies for market competitiveness and value. The Vice President is also responsible for the management of the PBM and other pharmacy related vendors as well as the Mail Order Pharmacy for USFHP. The Vice President will be responsible for ensuring PBM contract compliance and rebate optimization, ensuring full CMS and USFHP compliance.
They will also ensure optimal STARS and HEDIS performance with respect to Medication Adherence, analysis of population clinical data, and retail and specialty pharmacy spending for optimal clinical and fiscal management. This person will be a member of the Senior Leadership team and manage Medicare Advantage and USFHP pharmacy related programs, collaborating within the enterprise on pharmaceutical expense management, quality/utilization management and health plan/ practice operations.
Job Description
PRIMARY DUTIES AND RESPONSIBILITIES Provides strategic and operational leadership for the Pharmacy division to achieve organizational goals related to financial performance, sustainability, growth, and pharmaceutical management targets established through the strategic planning and budgeting processes. Directs the full scope of pharmacy operations, including formulary management, prior authorizations, formulary exceptions, medication adherence, patient accounting, billing practices, vendor billing oversight, and daily systems operations to ensure efficient, effective, and high-quality service delivery.
Ensures Pharmacy division readiness for payer, regulatory, contractual, and accreditation requirements, including preparation for the CMS MA bid process and compliance with all applicable vendor, payer, federal, state, and accreditation standards. Establishes and oversees pharmacy performance metrics, data analysis, and quality improvement initiatives to evaluate divisional performance, improve patient care outcomes, strengthen contracted performance, and identify opportunities for operational and strategic process improvement.
Ensures all pharmacy related policies are clinically sound with EBM criteria and have appropriate UM management activities, such as step therapy, for appropriate fiscal…
About Martins Point Generations Advantage
From its Form 990- Budget $745.8M · Health Care
- founded 2015
- Open jobs 26 · Jobs at Martins Point Generations Advantage · Full 990 report