VP Government Programs - Medicare & Managed Medicaid (REMOTE)

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Job Posting Title

VP Government Programs - Medicare & Managed Medicaid (REMOTE)

Job Description

The Vice President Government Programs - Medicare & Managed Medicaid is responsible for the development, administration, and execution of strategic plans that advance Prime’s position in the Medicare space. This position has accountability for the Medicare P & L, and provides oversight to the development, maintenance, and growth of Medicare products and services, and it ultimately responsible for driving growth of the Medicare market segment.

Responsibilities

• Provide leadership and oversight to the Medicare and Medicaid teams and ensure the development and execution of goals that guarantee performance objectives are met and/or exceeded; instill a culture of compliance, accountability, and superior service within the Government Programs organization; establish team level performance goals and objectives, as well as measurement techniques, ensuring strong engagement and motivation
• Serve as a government programs expert, collaborating with the executive team and board of directors to reach a shared vision, set objectives for advancing Prime’s position in the Medicare/Medicaid markets, and drive the development of products and services across the enterprise to support growth objectives
• Oversee the expansion of PBM services to multiple states and measure the success of the Government Programs segments, including growth and positive P&L results; participate in existing and prospective client meetings in collaboration and close partnership with Prime’s Sales Team to drive growth in the Medicare and Medicaid markets and influence product adoption
• Manage financial performance, operating budget, and variances from plan to ensure cost effective delivery of service; design, develop, and implement annual operating budget and the Medicare Part D annual bid
• Partner with stakeholders and staff to define a strategy targeting existing and new individual and group Medicare business, including age-ins. Defines go to market approach and works with the team and government affairs to execute the strategy
• Establish key relationships with Government Program owners at the plans, and plan executives, consultants or other stakeholders to advocate for Prime’s government program offerings, align priorities, solicit feedback and recommendations and create solutions to address interest, concern or opportunity
• Act as a thought leader in national meetings where the company`s Medicare product and services are a focus; establish the company as a thought leader in the market helping to set policy
• Other duties as assigned

Minimum Qualifications

• Bachelor’s degree in Pharmacy, Analytics, Finance, Business, Health Care Administration, or related area of study
• 15 years of relevant work experience in PBM, pharmacy, health plan and/or managed care with a minimum of 8 years in Medicare and/or Medicaid in a health plan, healthcare consulting firm, PBM, or other government environment
• 9 years of leadership/people management experience

Additional Qualifications

• Strong skills in developing comprehensive strategy to drive growth in government programs (Medicare and/or Managed Medicaid)
• Proven track record of leadership with results in the healthcare industry and recognition for government program expertise; strong understanding of Medicare Part C and D rules and regulations
• Exceptional client relationship management and cross-functional team building skills; ability to establish trust, build rapport, and collaborate effectively internally and externally and at various levels of an organization
• Strategic thinking and long-range planning skills with the ability to design, execute, and link multiple projects over time to achieve a future strategic goal looking beyond the present situation to conceptualize key trends and identify changing market demands
• Excellent facilitation, communication, presentation, and consultative skills; demonstrated ability to distill complex concepts or situations into concise and compelling communications

Preferred Qualifications

• Master’s degree or other advanced degree
• 5+ years of work experience in Pharmacy Benefit Management (PBM)

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures

Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.

Potential pay for this position ranges from $232,000.00 - $441,000.00 based on experience and skills.

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 proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. _ _

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

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

At Prime Therapeutics (Prime), we are a different kind of PBM. We’re reimagining pharmacy solutions to provide the care we would want for our loved ones. That purpose energizes our team and creates limitless opportunities to make a difference.

We know that people make all the difference. If you’re ready for a purpose-driven career and are passionate about simplifying health care, let’s build the future of pharmacy together.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.     

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email [email protected].

If you have questions about this posting, please contact [email protected]