Talent.com
Director, Pharmacy Operations

Director, Pharmacy Operations

RxSenseBoston, MA, US
job_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

Job Description

Job Description

We are a healthcare technology company that provides platforms and solutions to improve the management and access of cost-effective pharmacy benefits. Our technology helps enterprise and partnership clients simplify their businesses and helps consumers save on prescriptions.

As a leader in SaaS technology for healthcare, we offer innovative solutions with integrated intelligence on a single enterprise platform that connects the pharmacy ecosystem. With our expertise and modern, modular platform, our partners use real-time data to transform their business performance and optimize their innovative models in the marketplace.

Position Summary :

The Director of Pharmacy Operations is a strategic leadership role responsible for overseeing RxSense's pharmacy provider network strategies and operations. This role involves leading cross-functional teams, developing innovative solutions, managing critical vendors and partners, and ensuring the delivery of high-quality, competitive pharmacy services to clients. The ideal candidate will bring significant healthcare or PBM industry experience (10+ years), proven success in managing large teams, and a strategic mindset to drive process improvements, organizational growth, and business resiliency. This individual will serve as a trusted partner across the organization, influencing decision-making and driving results in a highly dynamic environment.

Essential Duties and Responsibilities :

Strategic Leadership

  • Act as the primary leader for RxSense's Pharmacy Network Operations, ensuring alignment with organizational goals, regulatory standards, and evolving client needs.
  • Define and implement long-term strategies to optimize pharmacy network performance, cost efficiency, and market competitiveness.
  • Establish and execute key performance indicators (KPIs) to measure provider value, network accessibility, service quality, and operational impact.

Team Leadership and Development

  • Build, lead, and mentor a high-performing, cross-functional team, fostering a culture of accountability, innovation, and continuous professional development.
  • Provide hands-on coaching and structured growth opportunities to support team advancement and internal talent pipelines.
  • Pharmacy Network & Vendor Management

  • Direct the development, expansion, and optimization of RxSense's pharmacy networks, ensuring provider diversity, geographic reach, and service excellence.
  • Negotiate and manage strategic pharmacy contracts that support cost containment, quality, and member access.
  • Lead all aspects of pharmacy credentialing, auditing, and URAC accreditation readiness to meet federal, state, and industry-specific standards.
  • Oversee performance of key vendors and partners (e.g., fulfillment, specialty, claim processors, network partners) including SLA management, audits, and issue resolution.
  • Risk Management, Audit & Quality Control

  • Implement robust internal controls, audit frameworks, and quality assurance programs across pharmacy operations.
  • Lead proactive risk identification, root cause analysis, and remediation strategies to ensure long-term stability.
  • Coordinate periodic internal and external audits, ensuring audit readiness and corrective action plans.
  • Client and Stakeholder Engagement

  • Serve as a senior client-facing representative for RxSense, managing escalations and ensuring high-quality, solution-oriented service delivery.
  • Partner with internal departments—such as Sales, Client Success, Implementation, and Compliance to support RFPs, implementations, renewals, and client strategy.
  • Represent RxSense in external industry forums, associations, or regulatory working groups as needed.
  • Operational Excellence & Change Leadership

  • Establish, document, and maintain Pharmacy Operations policies and procedures to ensure consistency, scalability, and audit readiness.
  • Identify and implement process improvement initiatives, using data and analytics to drive automation, reduce risk, and enhance efficiency.
  • Lead organizational transformation, process scaling, and change management efforts, ensuring smooth adoption of new systems, processes, and integrations.
  • Proactively troubleshoot complex issues, lead root-cause analysis, and ensure long-term, sustainable resolution pathways are documented.
  • Regulatory Compliance & Policy Intelligence

  • Partner with Legal and Compliance to ensure enterprise-wide compliance with applicable federal and state laws, CMS requirements, and commercial payer standards.
  • Lead and maintain efforts for URAC accreditation, including documentation, policy updates, and audit preparation.
  • Technology & Systems Ownership

  • Partner closely with Product and Technology teams to enhance pharmacy network system needs are met.
  • Serve as an internal subject matter expert on operational technology, ensuring systems support scalability, compliance, and client needs.
  • Business Continuity & Resiliency

  • Develop and maintain business continuity and disaster recovery plans for pharmacy operations, ensuring resiliency during system outages or disruptions.
  • Coordinate contingency planning for provider network disruptions, data system failures, and critical operational risks.
  • Qualifications :

  • Bachelor's degree; advanced degree preferred (e.g., MBA, MPH, or similar), or equivalent professional experience in pharmacy benefits, healthcare, or related field
  • 10+ years of relevant experience in healthcare, PBM, or pharmacy network operations.
  • Proven success in leading cross-functional teams and managing large-scale projects or initiatives.
  • Extensive experience in pharmacy benefits, network contracting, compliance, and provider relations.
  • Strong strategic thinking and problem-solving abilities with a track record of influencing organizational outcomes.
  • Experience leading teams in a matrixed environment, with a focus on mentorship and professional development.
  • Technical Knowledge :

  • Familiarity with KPIs, analytics, and operational dashboards to measure performance.
  • Knowledge of systems integrations, automation tools, and operational technologies.
  • Ability to travel as needed (up to 25%)
  • Salary Range : $112,000 - $168,000

    RxSense believes that a diverse workforce is a more talented and productive workforce. As such, we are an Equal Opportunity and Affirmative Action employer. Our recruitment process is free from discriminatory hiring practices and all qualified applicants are considered for employment without regard to race, color, religion, sex, gender, sexual orientation, gender identity, ancestry, age, or national origin. Neither will qualified applicants be discriminated against on the basis of disability or protected veteran status. We believe in the strength of the collaboration, creativity and sense of community a diverse workforce brings.

    serp_jobs.job_alerts.create_a_job

    Pharmacy Pharmacy • Boston, MA, US

    Job_description.internal_linking.related_jobs
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    State Licensed VP of LTSS Operations

    State Licensed VP of LTSS Operations

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for a VP of LTSS - Health Care Operations.Key Responsibilities Provide executive strategy and leadership for long-term services and supports (LTSS) operations and compliance ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_less
    • serp_jobs.job_card.promoted
    Director of Technical Operations

    Director of Technical Operations

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director of Technology Operations.Key Responsibilities Lead and develop a global team of Technical Operations Engineers, establishing a customer-centric culture Overse...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Director of Logistics Operations

    Director of Logistics Operations

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director of Logistics & Delivery Experience.Key Responsibilities Define and execute the delivery and shipping strategy, including carrier selection and optimization Ov...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Director of Supply Chain Operations

    Director of Supply Chain Operations

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director of Supply Chain & Warehouse Operations.Key Responsibilities Lead the end-to-end supply chain strategy, including procurement, inventory management, demand plan...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Technical Operations Director

    Technical Operations Director

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for a Technical Operations Director (Remote).Key Responsibilities Oversee day-to-day business technical support for systems related to claims, service, and membership Manage...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Vice President of Sales Operations

    Vice President of Sales Operations

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for a Vice President of Mortgage Sales Operations to lead their nationwide contact center team.Key Responsibilities Lead and scale a high-performing, multi-site call center o...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    EOR Operations Principal

    EOR Operations Principal

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for an EOR and Operations Principal.Key Responsibilities Ensure compliance with federal, state, and local employment laws Maintain and update HR policies and employee record...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Senior Associate, Market Operations

    Senior Associate, Market Operations

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for a Senior Associate, Market Operations Support.Key Responsibilities Develop standardized, scalable processes and workflows to address market needs and monitor performance ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Pharmacy Operations Specialist

    Pharmacy Operations Specialist

    VirtualVocationsDorchester, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for a Pharmacy Operations Specialist who will support pharmacy utilization management programs and provide customer service. Key Responsibilities : Process and review prior aut...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Director of Sales Operations

    Director of Sales Operations

    VirtualVocationsDorchester, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director, Sales Operations to strengthen sales infrastructure and drive growth.Key Responsibilities Own the accuracy and health of the sales pipeline across segments an...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Pharmacy Performance Manager

    Pharmacy Performance Manager

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for a Manager, Aetna Pharmacy Performance & Profitability Management.Key Responsibilities Support enterprise-wide initiatives by assessing their impact on Aetna and providing...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_less
    • serp_jobs.job_card.promoted
    Director of Business Operations

    Director of Business Operations

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director, Business Operations & Strategy (Marketplace Growth).Key Responsibilities Own the systems, strategy, and execution behind the quoting engine, automation infras...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Director of Quality Improvement

    Director of Quality Improvement

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director, Quality Improvement HEDIS Operations.Key Responsibilities Lead and direct process improvement activities for HEDIS operations Collaborate with the Medicare S...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Pharmaceutical Account Manager

    Pharmaceutical Account Manager

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for an Account Manager, Client Success.Key Responsibilities Manage day-to-day client relationships with Pharmaceutical manufacturer customers Analyze and deliver monthly pro...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Illinois Licensed Clinical Pharmacist Manager

    Illinois Licensed Clinical Pharmacist Manager

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    Manager Pharmacist Clinical Capabilities, Remote.Key Responsibilities Anticipates customer needs and develops proactive solutions Serves as a key resource on complex issues and provides recommen...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Director of Strategic Accounts

    Director of Strategic Accounts

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director of Strategic Accounts.Key Responsibilities Cultivate new relationships and expand presence in the biotech and Pharma sector Develop and execute outbound strat...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Clinical Pharmacy Manager

    Clinical Pharmacy Manager

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for a Clinical Pharmacy Manager.Key Responsibilities Oversee medication management services within designated regions Provide management and support for clinical pharmacy te...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Director of Specialty Operations

    Director of Specialty Operations

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director, Specialty Operations to lead back-office processing teams in Specialty Services.Key Responsibilities : Lead and manage the delivery of a shared service team pe...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Executive Director, Quality Operations

    Executive Director, Quality Operations

    ArdelyxWaltham, MA, United States
    serp_jobs.job_card.full_time
    Ardelyx is a publicly traded commercial biopharmaceutical company founded with a mission to discover, develop and commercialize innovative first-in-class medicines that meet significant unmet medic...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Director of R&D

    Director of R&D

    VirtualVocationsLowell, Massachusetts, United States
    serp_jobs.job_card.full_time
    A company is looking for a Director of R&D.Key Responsibilities Develop and execute the company's long-term R&D and innovation strategy Oversee the entire product development lifecycle from conc...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days