The PBM Program Manager leads the end-to-end Request for Proposal (RFP) process for selecting and contracting with Pharmacy Benefit Managers, ensuring alignment with organizational goals, cost containment strategies, and regulatory requirements. They develop customized RFP documents and evaluate PBM proposals using structured scoring models, based on the Plan direction, comparing pricing, rebates, formulary design, and service capabilities. The role involves collaborating with PBMs and internal Pharmacy & Therapeutics (P&T) Committees or direction of Deputy Executive Administrator to design effective and compliant formularies, considering CMS guidelines, drug tiering strategies, and generic vs. brand drug utilization. The Program Manager supports data analysis related to drug utilization and financial performance, manages vendor relationships and deliverables, and fosters collaboration across vendor teams. Additionally, they mentor team members to support their role growth and contribute to overall program success. Lead the end-to-end Request for Proposal (RFP) process for selecting and contracting with PBMs Excellent written communication skills Help develop customized RFP documents that reflect organizational goals, cost containment strategies, and regulatory requirements Experience with Evaluating PBM proposals using structured scoring models, comparing pricing, rebates, formulary design, and service capabilities Formulary and Drug Tiering Strategy Collaborate with PBMs and internal Pharmacy & Therapeutics (P&T) Committees to design sound and cost-effective formularies Some knowledge of formulary design with CMS guidelines for commercial plan requirements Understanding of Generic and Brand drug strategy Some knowledge to analyze data, drug utilization trends, and financial performance is preferred Provide support managing the end-to-end relationships with assigned vendors RFP creation and evaluation process o Vendor relationship management
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This is a high PRIORITY requisition. This is a PROACTIVE requisition
Background Check : Yes
Drug Screen : Yes
Program Manager • United States