Team Leader - Pharmacy Business Support (PBM Oversight)

Wellmark•Des Moines, IA

4d•Hybrid

About The Position

Wellmark is seeking a Team Leader of Pharmacy Business Support to lead and develop a growing Pharmacy Performance team responsible for oversight of Wellmark’s Pharmacy Benefits Manager (PBM) and other pharmacy vendors. The role focuses on strengthening vendor oversight, identifying process gaps and risks, and using data and critical thinking to improve efficiency and performance. The Team Leader will coach and develop employees, set clear expectations and accountabilities, facilitate change, and foster a positive work environment while modeling Wellmark’s Leader Success Expectations. The position works a hybrid schedule with at least three days in Wellmark’s Des Moines office and the option to work remotely two days per week. Additional office days may be needed to meet business needs. The role requires a non-compete agreement.

Requirements

Bachelor’s degree in business, health care administration, or a related field, or equivalent experience.
At least 4 years of experience in health insurance, operations, PBM, or pharmacy benefit administration.
Demonstrated leadership experience with cross-functional or matrixed teams.
Leadership experience gained through a combination of project or informal leadership.
Ability to operate with agility and flexibility and move effectively among strategy, tactics, and operations.
Strong understanding of pharmacy benefit design, claims processing, and vendor oversight.
Ability to measure, evaluate, or improve work processes, programs, and services and ensure alignment with strategic goals.
Strong written and verbal communication skills, including the ability to communicate effectively with varied audiences and vendor partners.
Understanding of applicable rules, regulations, and guidelines, including awareness of their implications for the department.
Strong consulting and critical-thinking skills, including providing insights and recommendations, influencing others to act, and producing customer-focused solutions.
Effective time management and organizational skills, including prioritizing initiatives, aligning resources, articulating expectations, and motivating teams.
Adaptability and flexibility with change, including the ability to lead teams through change.

Nice To Haves

MBA or advanced degree in a related field.
Experience working with vendors such as CVS or other PBMs in a health plan setting.
Familiarity with Medicare Part D, compliance frameworks, and pharmacy data systems.
Formal people-leadership experience.
Proficiency in HROR.

Responsibilities

Lead and manage financial and human resources, with a focus on employee coaching, development, performance improvement, coordination, and budgeting for staff and department functions and services.
Support business objectives and deliver effective, accurate, timely results that meet business and stakeholder needs.
Identify, monitor, and communicate critical business metrics to support project execution and future process improvements.
Serve as the primary liaison with CVS for non-clinical pharmacy benefit matters and ensure accurate implementation of Wellmark’s business requirements.
Oversee quality assurance, compliance monitoring, and performance tracking for PBM services and internal pharmacy support functions.
Communicate operational strategy and initiatives to team members and drive customer and stakeholder service.
Collaborate with the Pharmacy Product team on product strategy, roadmap planning, and subject matter expertise.
Ensure adherence to contractual, regulatory, and accreditation standards, including CMS, HEDIS, and NCQA, through effective oversight and documentation.
Represent non-clinical pharmacy perspectives in cross-functional workgroups and strategic planning efforts.
Promote accountability, innovation, and service excellence across the team.
Partner with Compliance, Legal, Product, Technology, and other internal stakeholders to resolve issues promptly and align with enterprise priorities.
Monitor and analyze performance metrics to identify trends, risks, and improvement opportunities.
Contribute to developing and maintaining policies, procedures, and training materials for consistent and compliant execution.
Perform other duties as assigned.