Pharmacy Product Manager
About The Position
The Pharmacy Product Manager is responsible for the development, implementation, and management of pharmacy products, including Service Area Expansion application submission to CMS, Request for Proposal support, Market Pharmacy benefits analysis and industry/drug trends, production of the pharmacy-related customized communication and marketing materials. The Pharmacy Product Manager is responsible for leading and supporting the implementation of Medicare Part D provisions under the Inflation Reduction Act (IRA), CMMI initiatives and oversight of the Medicare Prescription Payment Plan (M3P). This position ensures alignment with organizational goals, regulatory compliance, and operational excellence. This role collaborates cross-functionally with internal teams and external partners to drive the design and execution of pharmacy initiatives that optimize member experience and operational performance. The Manager has accountability for fulfilling the organization’s mission, managing cost of pharmacy care, growth and profitability. The Manager stays abreast of pharmacy, PBM and payer industry changes, best practices, and CMS’s rules and regulations.
Requirements
- 3–5 years of experience in pharmacy benefits management, managed care pharmacy, or product management within healthcare.
- Bachelor's Degree or equivalent experience required.
- Expertise with Medicare Part D and/or Medicaid pharmacy programs
- Experience working with PBMs and cross-functional teams in a health plan or pharmacy operations setting.
- Proven project management experience applying industry methodologies and practices.
- Ability to manage and adapt to a significant change.
- Strong leadership skills, including excellent interpersonal, communications, problem- solving and negotiating skills.
- Strong analytical and problem-solving skills.
- Strong analytical and critical thinking skills, required.
- Ability to manage multiple projects simultaneously with strong attention to detail.
- Knowledge of CMS Part D regulations and pharmacy benefit design
- Ability to work cross-functionally and collaboratively across the organization.
- Ability to think strategically and act tactically.
- Technologically savvy and able to utilize information systems effectively.
- MS Office (Word, Excel, PowerPoint, Access), Visio, and SQL.
- Strong interpersonal skills, including excellent written and verbal communication skills.
- Strong organizational skills
- Ability to appropriately maintain confidentiality.
Nice To Haves
- PharmD, MBA, Graduate or related advanced degree preferred.
Responsibilities
- Lead the development of pharmacy products, including service area expansion and submission to CMS, ensuring alignment with regulatory requirements, market needs, and organizational objectives.
- Collaborate with internal & external stakeholders including pharmacists, PBMs, developers, compliance teams, and marketing to gather requirements, prioritize features, and ensure successful implementation of pharmacy initiatives.
- Collaborate with data analytics teams to conduct prescription benefit market analysis, evaluate competitors offerings per each service area and identify industry trends to generate product enhancements.
- Monitor and analyze product performance, including utilization trends, financial impact and member experience, identifying opportunities for improvement.
- Support operational readiness for Annual Enrollment Period (AEP) and product launches, including production of the pharmacy-related customized communication and marketing materials.
- Perform AEP staff training and cross-functional alignment.
- Support RFP process, including evaluation criteria, to optimize pharmacy benefit operations, financial performance, and member experience.
- Contribute to the development and maintenance of policies, procedures, and training materials.
- Maintain professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies.
- Serve as a subject matter expert on pharmacy products and benefits, supporting cross-functional teams during CMS and state regulatory audits, including CMS Part C and D Data Validation audits.
- Prepare presentations and updates to leadership regarding product performance, upcoming initiatives, and regulatory changes.
- Ensure products meet HIPAA, FDA, CMS, and other pharmacy-related regulatory standards.
- Maintain current knowledge of Medicare Part D regulations by participating in CMS calls and reading released guidance and implementing changes to maintain compliance.
- Serve as the subject matter expert on the Inflation Reduction Act’s Medicare Part D provisions, CMMI initiatives and Medicare Prescription Payment Plan.
- Foster strong relationships with PBM partners to align on product implementation, service delivery, and continuous improvement initiatives.
- Participate in the annual BID cycle development process.
- Actively support the achievement of SCAN’s Vision and Goals.
- Other duties as assigned.
Benefits
- Base salary range: $106,200 to $153,705 per year.
- Internal title: Pharmacy Product Mgr
- Work Mode: Remote
- An annual employee bonus program
- Robust Wellness Program
- Generous paid-time-off (PTO)
- 11 paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
- Excellent 401(k) Retirement Saving Plan with employer match and contribution
- Robust employee recognition program
- Tuition reimbursement
- An opportunity to become part of a team that makes a difference to our members and our community every day!
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What This Job Offers
Job Type
Full-time
Career Level
Manager
