PerformRx;is a Pharmacy Benefits Manager (PBM) dedicated to clinical culture, boutique service, and holistic solutions. Our mission is to help customers, doctors, and patients use effective medication therapy to improve health and wellness. For more than 15 years, our focus has been on providing optimal service through a clinical culture that seeks to provide members with high-quality care while ensuring our partners receive favorable costs. That culture is reflected in our employees - more than 80 percent of our staff members are Pharmacists and Pharmacy Technicians - and in the services we provide. PerformRx is headquartered in Philadelphia. Our dedication to innovation and to providing the most efficacious outcomes is the core of our clinical culture and is the heart of PerformRx. PerformRx is a subsidiary of the AmeriHealth Caritas Family of Companies. **Summary:** The Director, PerformRx Encounter/PDE (Prescription Drug Encounters) Management is responsible for the end-to-end encounter and PDE compliance and issue resolution across the PerformRx enterprise. This includes accountability for owning federal and individual state’s requirements regarding encounters/PDEs, including submission requirements, ensuring contractual compliance, and achieving key metrics. The incumbent will also drive enterprise encounter/PDE solutions to enhance the overall management of encounter/PDE requirements, compliance, and coordination with downstream vendors supporting these functions. This includes initial setup, implementation, and maintenance. The scope of this role is encounter/PDE management for the enterprise’s portfolio of product lines, health plans, and other potential projects and product types. ; ; **This position will also lead an encounter team with the following essential functions:** + Understand, interpret, and own each individual state’s encounter/PDE requirements and PerformRx’s compliance with each set of requirements + Track, monitor, and drive resolutions to ensure achievement of key metrics per contractual requirements; oversee enterprise encounter resolution; own the resolution of all encounter/PDE errors, including coordination with key departments, provider maintenance, claims, clients, enrollment, etc. + Oversight of quality of sub-con encounters and appropriate oversight of resolution of any errors (operational or system mapping) + Trend of issues and identification of enterprise remediation and solutions; standardization and enhancement with the goal of improving day-to-day business operations and increased encounter acceptance + Create and distribute standardized reporting and dashboards for the tracking of compliance and key issues + Compile and present performance metrics and issue resolution efforts to internal and external senior leaders **Education/Experience:** + Bachelor’s Degree in Business, Healthcare, or Management or equivalent work experience;required + Minimum eight (8) years of current/recent progressively advanced experience in healthcare operations to include management of staff, with a minimum of five (5) current/recent years in the following areas with subject-matter expertise in at least one area: claims, enrollment, provider and member data management, or encounter management;required + Experience in environments with large, complex, real-time transaction volumes desired **Requires:** + Demonstrated ability to build and foster effective relationships + Demonstrated ability to influence the decision-making process with individuals at all levels, including C-level executives + Creative problem-solving skills + Experience analyzing and defining solutions to complex business and technical issues + Experience in managing multiple, large, cross-functional teams and projects, with an eye toward identifying and implementing opportunities to improve business processes Your career starts now. We’re looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we’re passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we’d like to hear from you. Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com **Diversity, Equity, and Inclusion** At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable being themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve. We keep our associates happy so they can focus on keeping our members healthy. **Our Comprehensive Benefits Package** Flexible work solutions include remote options, hybrid work schedules, competitive pay, Paid Time Off (PTO), including holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k), tuition reimbursement, and more. As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.