VP of PBM Operations
Summary
If the following job requirements and experience match your skills, please ensure you apply promptly.
The Vice President of Pharmacy Benefit Manager (PBM) Operations is responsible for end-to-end delivery of all operational aspects of the PBM system.
This position will involve strategic planning, optimizing operational processes and ensuring the efficient delivery of the pharmacy benefit services.
Essential Duties And Responsibilities
- Develop and execute strategic plans for PBM operations to align with organizational goals.
- Oversee day-to-day operations, including claims processing, network, trade, clinical and other departments.
- Implement and enhance operational processes to improve efficiency, accuracy and customer satisfaction.
- Collaborate with cross-functional teams to ensure seamless integration of new programs and services.
- Monitor and analyze key performance indicators to identify areas for improvement and optimization.
- Foster a culture of continuous improvement, innovation, and excellence with the operations teams.
Qualifications
- Strong understanding of PBM processes, including claims adjudication, network development, clinical affairs, trade, contracting, systems and account management.
- Proven ability to lead and inspire cross-functional teams to achieve operational excellence.
- Strong analytical and problem-solving skills with attention to detail to address complex operational challenges.
- Excellent communication skills with internal and external stakeholders.
- Visionary mindset with the ability to anticipate and navigate changes in the healthcare landscape.
- Proficient with GSuite applications- Docs, Slides, Sheets, etc.
EDUCATION And / or EXPERIENCE
- Bachelor's degree and 15+ years equivalent experience in business, healthcare administration or a related field and / or pharmacy;
- advanced degree is a plus. Masters or Doctorate degree and 10+ years equivalent experience in business, healthcare administration or a related field and / or pharmacy;
advanced degree is a plus.
- Extensive experience in PBM operations with 8+ years in PBM leadership. Track record of leadership and strategic management.
- Knowledge of pharmacy segments (Commercial, Medicaid, Medicare).
- Experience in multiple pharmacy industry areas (Retail, Specialty Pharmacy, Health plan, PBM, Managed Care, etc.)
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this Job, the employee is regularly required to sit; use hands to handle or feel; talk; and hear.
- Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
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