Director of Payer Operations

| Hybrid
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Job Summary
Responsible for leading and directing activities associated with the operations, implementation and maintenance of executed contracts for third party programs (e.g. retail pharmacy, mail service, specialty pharmacy, infusion, take care retail clinics). Works cross-functionally (e.g. Sales, Store Operations, Marketing, Purchasing, Advertising, Information Technology, Accounting, Finance, Logistics, Distribution and Law) to coordinate contract administration for pharmacy and medical benefit programs including processing, billing, reimbursement, formulary and payment information. Ensures that policies and procedures are revised and implemented to address any operational issues that are identified on the Walgreens side. Knowledge and understanding of products and services, store/field operations and contracts as well as knowledge of the managed care and insurance industries and their respective business issues and potential opportunities.

Job Responsibilities

  • Partners with Director in determining and implementing the strategy across the organization.
  • Partners with the management team to identify, develop, and implement appropriate approaches, processes, and tools that elevate the analytics group.
  • Identifies, evaluates and recommends opportunities consistent with business objectives; provides marketing support to throughout the organization.
  • Works to identify and develop analytics, strategies and programs in collaboration with business team. Communicates new ideas to director.
  • Delivers presentations and provides reports for the business to provide best practice information which may include industry trends, methodologies, new tools, and processes. Serves as subject matter expert in one or more areas.
  • Works with external vendors and third parties to develop and maintain positive relationships. Builds and enhances internal and external partnerships.
  • Proactively provides analytics and solutions to address key business capabilities.

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Walgreens Disclaimer-

An Equal Opportunity Employer, including disability/veterans

Walgreens (walgreens.com), one of the nation's largest drugstore chains, is included in the Retail Pharmacy USA Division of Walgreens Boots Alliance, Inc. (Nasdaq: WBA), a global leader in retail and wholesale pharmacy. Walgreens is proud to be a neighborhood health, beauty and retail destination supporting communities across the country, and was named to FORTUNE* magazine’s 2019 Companies that Change the World list. Approximately 8 million customers interact with Walgreens in stores and online each day. As of August 31, 2019, Walgreens operates 9,277 drugstores with a presence in all 50 states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands, along with its omnichannel business, Walgreens.com. Walgreens also provides specialty pharmacy and mail services and offers in-store clinics and other health care services throughout the United States, most of which are operated by our health care strategic partners.

Basic Qualifications

  • Bachelor's degree and at least 4 years of experience in healthcare industry OR High School Diploma / GED and at least 7 years of experience in healthcare industry.
  • At least two (3) years’ experience in performing a combination of analysis, administration, or operations in the healthcare industry.
  • Experience establishing and maintaining key relationships with internal (peers, business partners and leadership) and external (business community, clients and vendors) within a matrix organization to develop strategies that meet department goals within budget and timelines.
  • Experience developing ways of accomplishing goals with no supervision, depending upon oneself and proper delegation to resolve issues to ensure completed objectives and determining when escalation of issues is necessary.
  • Experience using time management skills such as prioritizing/organizing and tracking details and meeting deadlines of multiple projects with varying completion dates.
  • Experience in diagnosing, isolating, and resolving complex business issues and recommending and implementing strategies to resolve problems.
  • Experience overseeing the performance of direct or indirect reports and being held accountable for their deliverables.
  • Advanced level skill in Microsoft Excel (for example: using AVERAGE function, merging and centering cells, printing centered page and/or creating a pivot table).
  • Advanced level skill in Microsoft PowerPoint (for example: changing picture styles, customizing animation and/or setting automatic slide timings).
  • Advanced level skill in Microsoft Word (for example: adding developer tab, creating a macro, formatting table style, inserting comments and/or creating a mail merge).
  • Experience with Operational Strategy development.
  • At least 2 years of experience planning, developing, and managing departmental expense and capital budgets.
  • At least 2 years of experience planning, developing, and managing departmental expense and capital budgets.
  • At least 2 years experience of direct leadership and/or cross functional team leadership.
  • Willing to travel up to 15% of the time for business purposes (within state and out of state).

Preferred Qualifications

  • Master’s degree / MBA
  • At least two (2) years’ experience implementing contracted Third Party programs in the healthcare industry.
  • At least two (2) years’ experience administering healthcare contracts.
  • At least two (2) years Payor and facility credentialing experience.
  • At least two (2) years medical reimbursement/fee schedule maintenance experience.
  • Infusion, Specialty Pharmacy, Retail Clinic, and/or Pharmacy Technician experience.
  • At least 2 years experience working in retail pharmacy operations.
  • Advanced degree in Math or Statistics
  • Experience using Walgreen proprietary systems (e.g. AS400, SIMS, POS, IC+)
  • At least 2 years working collaboratively with cross-functional teams.
  • Experience in identifying operational issues and recommending and implementing strategies to resolve problems. This would include using business and analytical skills to facilitate requirement sessions and documenting activity workflows and business requirements. Such process would involve experience in the direct and indirect managementof team members, including assisting in the development, training and assignement of work/projects to other team members.
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Location

Our new office space at the former US Postal Office on Van Buren in downtown Chicago is the ultimate office space. With an open work environment, inspiring local artwork and many amenities - it makes coming into the office a breeze. We also offer hybrid (part in office and part remote) opportunities

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