Director, Network Relations And Compliance

DST Systems, Inc. Kansas City , MO 64126

Posted 2 months ago

The speed of technology. The influx of data. Shifting regulations. Increased customer expectations.

That's where you'll find DST, helping clients find opportunity in ever-changing and complex customer, business, and regulatory requirements. Mastering complexity is a constantly changing and evolving challenge one that only a few people can embrace and thrive upon.

If you see your opportunity in complexity, then we are the right fit for you.

Job Description:

Organizational Overview

Argus Health is a DST Company promoting better health outcomes for consumers through clinical and technological innovations. We accomplish this by leveraging the robust technology foundation and powerful analytic resources that are the core of DST, with industry leading clinical expertise and strategic pharmacy and healthcare solutions. This unique scope and strength allows Argus to address challenges across the entire health continuum and deliver greater value for all of our customers.

Role Overview

The Director, Network Relations is responsible for overall relationship management with retail, mail and specialty pharmacy partners. Responsibilities include network contract negotiations, network development, network strategy and day to day issue resolution. This position will also be responsible for strategic analysis and negotiations pertaining to network management, complex contracting, and contracting efforts to drive business results.

Responsibilities

  • Responsible for managing all aspects of relationships with assigned pharmacy chains to achieve or exceed internal performance standards.

  • Negotiate multi-million dollar contracts with retail, mail and specialty pharmacy partners to ensure the best possible outcome for Argus.

  • Work collaboratively with executive panel and legal team.

  • Responsible for developing and managing unique network solutions that provide customer value and financial savings.

  • Ensure all network initiatives and processes are in compliance with all applicable state and federal laws.

  • Create and execute on overall pharmacy performance strategy by identifying opportunities to lower our clients cost.

  • Understand complex pharmacy financials and pricing metrics to ensure highly profitable outcomes within pharmacy network.

  • Implement new techniques to manage and optimize our client and pharmacy performance process.

  • Communicate with applicable chain pharmacy partners to exchange prescription data, identify process improvement opportunities and establish reconciliation standards.

  • Responsible for monitoring and tracking local/federal laws and regulations to identify pending legislative concerns and confirm network business practices are compliant with all active legislation.

  • Manage URAC team SME for all network related requirements.

  • Relationship manager with third party audit vendor to confirm financial initiatives are met, vendor contract compliance and identification of program enhancements.

  • Lead SIU product launch, maintain program initiatives and build product enhancements.

  • Lead pharmacy compliance team to confirm pharmacy licensing and insurance documents are properly captured and maintained.

  • Responsible for ensuring internal processes are compliant with all Laws and credentialing standard requirements.

  • Develop, manage and mentoring high quality, productive team members to achieve optimal performance.

  • Engage and assist in client calls to assist the team through network performance, network roadblocks, and upcoming modifications.

  • Work collaboratively with Account Management and senior management teams to identify and align pharmacy network contracting efforts with the goals and objectives of our internal stakeholders and customers.

  • Collaborate with IT department on enhancing emerging and established technology.

  • Meet or exceed established goals and have the strategic ability to see ahead and create and articulate new strategies and plans.

  • Assist in all special projects assigned by the Executive team.

Qualifications

  • Bachelor's degree required and MBA preferred.

  • 5 years' experience in pharmacy network experience or similar healthcare related environment(s).

  • Previous experience in contract negotiations along with executing a pricing model, and the ability to build out a roadmap.

  • Demonstrated ability to develop and build strong internal and external relationships.

  • Strong interpersonal, decision-making, financial and technical skills; must be able to introduce new ideas, and tools to improve performance.

  • Strong leadership, analytical, reporting, and coordination skills.

  • Superior verbal, written, and telephone communication skills.

Location:

Kansas City Missouri

DST is an equal opportunity employer and values a diverse and inclusive workplace. All qualified candidates will receive consideration for employment without regard to age, race, color, religion, genetic information, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law. For more information about Equal Opportunity in the Workplace please click here and here. DST is committed to working with and providing reasonable accommodation to job applicants with disabilities. If you are a qualified individual with a disability and need an accommodation or accessibility assistance to complete the online application, please contact us at PeopleCenter@dstsystems.com for assistance.


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Director, Network Relations And Compliance

DST Systems, Inc.