Pharmacy Programs Manager
Health Care Service Corporation•National, NV
•$92,700 - $167,500•Remote
About The Position
Provides comprehensive pharmacy network oversight and manages day-to-day operations with external pharmacy benefit managers across all Medicare plans. Continuously monitors network pharmacies to ensure pricing setup accuracy and maintain strict operational quality standards. Drives PBM vendor performance and operational integrity through claims research, rigorous testing of benefit design implementations, and direct oversight of PBM mail order and customer service functions. Ensures strict compliance with all Medicare, Medicaid, and enterprise regulatory standards.
Requirements
- Previous experience with pharmacy networks and/or health plans
- Project management experience.
- Verbal and written communication skills.
- Flexible and ability to perform under pressure.
- PC proficiency including Word and Excel and database experience.
Responsibilities
- Provides comprehensive pharmacy network oversight.
- Manages day-to-day operations with external pharmacy benefit managers across all Medicare plans.
- Continuously monitors network pharmacies to ensure pricing setup accuracy and maintain strict operational quality standards.
- Drives PBM vendor performance and operational integrity through claims research, rigorous testing of benefit design implementations, and direct oversight of PBM mail order and customer service functions.
- Ensures strict compliance with all Medicare, Medicaid, and enterprise regulatory standards.
Benefits
- health and wellness benefits
- 401(k) savings plan
- pension plan
- paid time off
- paid parental leave
- disability insurance
- supplemental life insurance
- employee assistance program
- paid holidays
- tuition reimbursement
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Upload and Match Resume
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
