Director of Cost Containment

Description

TrueScripts Management Services is a pharmacist-founded, fully transparent Prescription Benefit Manager that has been revolutionizing the PBM industry since 2014. Our mission is to build lasting relationships by providing prescription benefit expertise at a personal and customized level to ensure optimum value at the lowest possible cost. We are committed to lowering prescription drug spending, achieving clinically effective outcomes, and always delivering Amazing Care.Did we mention Amazing Care? Good! Because this is so much more than just our tagline. It is the foundation upon which our business was built. We believe that Amazing Care starts from within, and our culture is reflective of this philosophy.

Our team members enjoy:

• A wide range of health insurance options including medical, dental and vision
• A strong salary and bonus program
• A robust 401k and company match
• Truescripts is transitioning to an ESOP, a team member owned company! Each year team members are allocated shares of stock through our ESOP, a Qualified Retirement plan!
• Employee Assistance Program
• A wellness program including financial incentives, chiropractic and massage services, and fitness stipends
• Dream Manager Program (yes, it’s a real thing!)
• A cohesive, family-based culture
• Charitable contributions and volunteer time

Ok, enough about us. Here’s what we need from you: A future team members' values need to align with TrueScripts' core values of Integrity, Respect, Innovation, and Service. This match in value systems is critical for our team's chemistry and continued success. Our culture is positive, and our people possess a ‘can do, proactive attitude. Honesty and transparency are the foundation that we build upon. What sets us apart from our competitors is the programs that we bring, the education that we provide, and the utmost respect for clients and their members to assist them when and where needed.

Position Overview:  

The Director of Cost Containment Programs provides strategic leadership and oversight for TrueScripts Management Services' cost containment portfolio, ensuring programs deliver measurable value to clients. The director will be accountable for the development and ongoing maintenance of the application/tools utilized to manage the programs and ensure financial, clinical, and operational value is achieved and programs are compliant and achieve the company's growth strategy.

This role is accountable for the strategy, performance, optimization, and continuous evolution of TrueScripts' cost containment programs. The Director leads a team of Program Owners and partners closely with Business Development, Strategy, Clinical, Claims Administration, Client Success, Implementation, IT, Analytics, Member Services, and other business functions to ensure programs are effectively designed, implemented, measured, and continuously improved.

The Director serves as a strategic leader and subject matter expert for cost containment, identifying opportunities to increase client savings, improve program performance, automate processes, leverage technology, and develop new solutions that strengthen TrueScripts' competitive position.

This position will play a critical role in transitioning cost containment from a primarily operational function into a strategic, scalable, and measurable business capability.

Requirements

 Key Responsibilities:  Cost Containment Strategy & Program Development

• Partner with the TrueScripts Strategic Team to develop and execute the organization's overall Cost Containment strategy.
• Identify opportunities to create new programs or enhance existing programs that generate measurable value for clients.
• Evaluate market trends, PBM practices, emerging technologies, clinical opportunities, and client needs to identify new cost containment opportunities.
• Partner with Strategy and Business Development to develop business cases for new programs, including expected savings, investment requirements, operational impact, technology requirements, and scalability.
• Lead the design and development of new cost containment program operational capabilities from concept through implementation.
• Establish clear objectives, financial targets, KPIs, workflows, and success criteria for each program.
• Continuously evaluate whether existing programs are achieving their intended outcomes and identify opportunities to improve, redesign, expand, or retire programs.

Program Administration & Operational Excellence

• Own the overall administration model for TrueScripts' cost containment programs.
• Establish standardized processes, workflows, controls, and governance for program administration.
• Drive the administration of programs toward the most efficient and effective model possible.
• Identify opportunities to reduce manual work, eliminate unnecessary steps, and improve turnaround times.
• Ensure programs are administered consistently, accurately, and in accordance with program requirements.
• Establish clear accountability between Cost Containment, Customer Care, Clinical, Claims Administration, and other operational teams.
• Partner with Operations leaders  to ensure programs are executed effectively without unnecessarily increasing staffing requirements.
• Establish quality assurance and  performance monitoring processes.
• Continuously evaluate administrative processes to identify opportunities to increase savings and reduce operational cost.

Business Ownership of Cost Containment Technology

The Director will serve as the business owner and product leader for the applications, tools, and technology supporting Cost Containment programs.

• Define the business vision and requirements for Cost Containment applications and tools.
• Partner with the TrueScripts Strategic Team and IT/Product teams to develop technology solutions that support program administration.
• Develop and maintain the business roadmap for Cost Containment technology.
• Translate program requirements into business requirements, workflows, user stories, and functional specifications.
• Prioritize technology enhancements based on client savings, operational efficiency, scalability, and business value.
• Ensure applications are designed around the way TrueScripts needs to administer its programs rather than forcing business processes to conform to technology limitations.
• Lead business-side testing and validation of new functionality.
• Serve as the primary business subject matter expert during development and implementation.
• Identify opportunities to use automation, artificial intelligence, integrations, and data to improve program administration.
• Ensure technology solutions provide appropriate visibility into program performance, savings, workflow status, and outcomes.

Maximizing Client SavingsThe Director will be accountable for continuously improving the financial impact of TrueScripts' Cost Containment programs.

• Partner with Strategy and Business Development to establish methodologies for measuring program savings and financial impact.
• Partner with Analytics and Finance to validate savings methodologies and results.
• Monitor program performance against financial targets.
• Identify missed savings opportunities and develop corrective strategies.
• Evaluate program rules, workflows, interventions, and administration processes to maximize savings.
• Analyze program performance  across clients, populations, therapeutic categories, and other relevant dimensions.
• Identify opportunities to increase program adoption and effectiveness.
• Ensure savings opportunities are  not lost because of inefficient workflows, system limitations, lack of automation, or administrative processes.
• Develop reporting that clearly demonstrates the financial value of each program to internal executives and clients.

Program Portfolio Management

• Establish a comprehensive roadmap for the Cost Containment program portfolio.
• Prioritize initiatives based on  client impact, savings opportunity, regulatory requirements, complexity, and resources.
• Establish program-level KPIs and dashboards.
• Conduct regular program performance reviews.
• Identify dependencies between programs, claims administration, clinical processes, and technology.
• Ensure program changes are appropriately tested, documented, communicated, and implemented.
• Establish a formal process for evaluating proposed new programs and enhancements.
• Maintain visibility into program risks, opportunities, technology needs, and resource requirements.

Continuous Improvement & Innovation

• Establish a culture of continuous improvement across Cost Containment.
• Regularly evaluate whether existing processes represent the most efficient way to achieve desired outcomes.
• Identify opportunities for automation and artificial intelligence.
• Benchmark TrueScripts' programs and processes against industry practices.
• Develop innovative approaches to increase client savings.
• Challenge existing processes and assumptions when they limit savings, scalability, or efficiency.
• Develop a pipeline of future cost containment opportunities.

Compliance, Audit & Governance

• Partner with Strategy, Compliance and Legal to ensure programs meet contractual and regulatory requirements.
• Maintain appropriate documentation supporting program design, administration, and outcomes.
• Ensure program processes have appropriate controls and audit trails.
• Support regulatory, market conduct, client, and internal audits.
• Ensure program changes are appropriately documented, tested, approved, and implemented.
• Proactively identify compliance risks associated with program design or administration.

Leadership & Team Development

• Lead, develop, and coach Cost Containment Program Owners and other team members.
• Establish clear accountability for individual programs and initiatives.
• Develop Program Owners into subject matter experts and strategic business leaders.
• Establish consistent program management practices across the portfolio.
• Build a culture focused on innovation, accountability, client value, and continuous improvement.
• Identify future staffing and resource requirements based on program growth and automation opportunities.

Requirements:· Bachelor's degree in Business, Healthcare Administration, Pharmacy, Finance, Information Systems, or related field.· 7+ years of experience in healthcare, PBM, pharmacy benefits, managed care, or related industry.· 5+ years of progressive leadership experience.· Demonstrated experience developing and managing healthcare or PBM programs.· Strong understanding of pharmacy benefit management and cost containment strategies.· Experience translating business needs into technology requirements.· Experience working with technology or product development teams.· Demonstrated ability to manage complex cross-functional initiatives.· Strong financial and analytical skills.· Strong understanding of process improvement and operational efficiency.· Excellent communication and leadership skills. 

Working Conditions:

• Primarily remote position with some travel to the TrueScripts office in Washington, Indiana, for meetings, team events, training, and cultural activities as needed
• Estimated 25% travel required