Manager, Healthcare Performance Improvement
About The Position
The Performance Improvement Healthcare Consulting team helps healthcare organizations achieve sustainable results by addressing margin erosion through targeted improvement strategies. By aligning strategic, operational, and financial initiatives, the team identifies opportunities and supports leadership in implementing impactful changes. Its focus is on strengthening margins so providers can fulfill their mission and thrive in an evolving healthcare environment. The Manager will develop and execute enterprise-wide pharmacy strategies, lead pharmacy business planning, evaluate pharmacy operations and formularies, and oversee PBM relationships, payer contracting, billing, and pricing strategies. The role also advises clients on 340B compliance and optimization, implements split-billing solutions, supports HRSA audit readiness, and leads 340B network expansion and financial reporting. The position advises executive leadership, delivers presentations and recommendations, builds client partnerships, represents the organization in industry forums, and leads and develops cross-functional teams and junior staff.
Requirements
- Bachelor’s degree in Business, Pharmacy, Technology, Health Services Administration, or a related field, or a Doctor of Pharmacy (PharmD).
- At least 5 years of relevant pharmacy experience.
- Experience with pharmacy performance improvement projects, including qualitative and quantitative tasks.
- Proficiency in Microsoft Office Suite.
Nice To Haves
- Master’s degree.
- Certified Pharmacy Technician (CPhT).
- Prior consulting experience.
- Data visualization experience in Power BI or Tableau.
Responsibilities
- Develop and execute enterprise-wide pharmacy strategies aligned with organizational goals, including specialty pharmacy, entity-owned models, and payer engagement.
- Lead pharmacy business planning to optimize workflows, financial performance, and regulatory compliance across healthcare settings.
- Evaluate onsite pharmacy operations and formularies to identify cost-saving opportunities, improve outcomes, and enhance patient access.
- Oversee PBM relationships and lead payer contracting to maximize reimbursement and support value-based care.
- Direct pharmacy billing and pricing strategies to ensure accuracy, transparency, and regulatory alignment.
- Advise clients on 340B program compliance, optimization, and risk mitigation.
- Implement and maintain split-billing vendors, including crosswalk development and system integration.
- Conduct compliance reviews and support HRSA audit readiness.
- Expand and manage 340B networks, including contract pharmacies, child sites, direct purchasing, and orphan drug strategies.
- Lead 340B financial reporting and compliance initiatives to ensure transparency and regulatory alignment.
- Advise executive leadership on pharmacy performance, compliance risks, and strategic growth.
- Deliver presentations and recommendations to cross-functional teams to drive decision-making.
- Ensure exceptional client experiences through tailored solutions and long-term partnerships.
- Represent the organization in industry forums, contributing thought leadership and market insights.
- Mentor junior staff and foster a high-performance culture through coaching and development.
- Build and lead cross-functional teams to drive collaboration, accountability, and continuous improvement.
Benefits
- Robust total rewards program.
- Flexible work environment.
- Learning and growth opportunities.
- Workplace focused on relationships and employee well-being.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
