Atlanta, Georgia, United States of America

Guardian Pharmacy is a fast-growing company seeking top talent. We are looking for a team member to join our fast-paced, growing team. We need someone who understands the importance of our challenges, and also has the drive to make an impact as we achieve our goals.

Guardian Pharmacy Services, a leading Long-Term Care Pharmacy with nearly $1B in annual revenue from 43 pharmacies covering 25 states. Guardian serves more than 6,000 Senior Living Communities and more than 150,000 residents through its closed-door pharmacies. The Program Manager / Director of Medicare Benefits and Patient Services, who reports to the VP of PBM Network Operations, is responsible for developing a year-round program and plan for Guardian pharmacies to address resident and community needs regarding Medicare Plans, their eligibility, and options along with the possibility to save on out-of-pocket costs on prescription drugs. Over time, hire 15-20 Regional Plan Benefits Navigators to support local pharmacies, residents, and communities in Medicare Benefits. In addition, the Director will support the VP of PBM Network Operations on Strategy development as it relates to National Accounts, Health Plans, and PBMs.

ESSENTIAL JOB FUNCTIONS (include The Following)

Medicare Benefits and Patient Services

Develop and implement a comprehensive year-round program for Guardian pharmacies to address the needs of residents and communities regarding Medicare plans, eligibility, options, and opportunities to save on out-of-pocket costs.
Develop a communication strategy, messaging, and marketing materials in coordination with various departments (e.g., billing, finance, sales, and account management) to promote program objectives.
Increase awareness of plan eligibility, coverage options, and enrollment periods to new and existing customers through educational and marketing initiatives.
Develop partnerships with national senior living accounts to support their plan adoption objectives.
Hire and supervise Regional Plan Benefit Navigators working at pharmacies with a dotted-line reporting relationship to the local pharmacy billing team.
Serve as a subject matter expert for Enliven software, ensuring proper training, tracking, and use of the product to create Medicare Plan comparisons.
Establish partnerships with vendors providing access to Licensed Medicare Agents for additional resident support with the goal of improving the overall member experience.
Collaborate with vendors to enhance offerings, develop joint marketing strategies, and streamline processes from plan comparison to self-enrollment and agent support.
Ensure compliance with all Medicare regulations.
Track and report on key metrics of program performance.
Develop and maintain a Medicare plan database to support local pharmacy teams and manage PBM contracts.
Provide training, rollout, and support to local pharmacy teams as needed.

Lead and Develop Team

Supervise 1-3 Medicare part-time subject matter experts.
Assist with hiring and leading new Healthcare Benefits Navigator role for local/regional pharmacy support (expected 15-20 employees over time).

Project Management

Develop and implement project plan, communication, training and support metrics for both Medicare Special Enrollment Periods and Annual Enrollment Periods.

Support Guardian initiatives

Support VP PBM Network Operations on the development, preparation, and communication of Medicare Strategy
Present key topics as necessary to Presidents, DFAs, and billing teams at Leadership Meetings.
Other essential functions and duties may be assigned as needed.

Education And/Or Certifications

Bachelor’s Degree required.
MBA preferred.

Skills And Qualifications

10 years of Medicare experience and subject matter expertise
Proven leadership skills to develop and lead a team to deliver on responsibilities.
Must possess exceptional communication and project management skills and the ability to operate effectively (consultant-type skills).
Subject Matter Expert in Medicare, Medicaid, and commercial plans
Excellent written and verbal communication skills are required, along with the ability to work to deadlines.
Must have a strong working knowledge of LTC pharmacy operating systems and related technology.
Experience in fast-growth, multiple-location business structures is also preferred.
Advanced computer skills: pharmacy operations system experience preferred.
Ability to work independently and deliver to meet deadlines.
Ability to solve problems with minimal direction.
Great attention to detail and accuracy.
Ability to excel in a fast-paced, team-oriented environment working on multiple tasks simultaneously, while adhering to strict deadlines.
Quality-minded; motivated to seek out errors and inquire when something appears inaccurate.

Full-Time employees working 30+ hours per week are eligible to enroll in our comprehensive benefits package, which includes medical, dental, vision, short and long-term disability, life and supplemental life insurance, and PTO.

All employeesare eligible to enroll in our company matched 401(k) plan.