Team Leader - Pharmacy Business Support (PBM Oversight)

Wellmark, Inc.•Des Moines, IA

5d•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, improving efficiencies, and supporting work related to the total cost of health care. It requires effective communication and partnership-building across the organization and with external vendors, as well as critical thinking, data-informed decision-making, strategic problem-solving, and the ability to influence collaboratively. The Team Leader directly supports team members’ success, growth, and development by setting clear expectations and accountabilities, coaching regularly, facilitating change, and fostering a positive work environment. The leader is expected to model Wellmark’s Leader Success Expectations and guide teams with flexibility and resilience. This 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 required to meet business needs. The role provides day-to-day leadership and management of financial and human resources, oversees PBM service quality and compliance, and serves as the primary liaison with CVS for non-clinical pharmacy benefit matters. It also collaborates with Pharmacy Product and enterprise stakeholders, monitors performance, supports strategic initiatives, and helps maintain compliant policies, procedures, and training materials. A non-compete agreement is required.

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 and the ability to move effectively between strategy, tactics, and operations.
Leadership experience gained through project or informal leadership.
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 the ability to provide insights and recommendations, influence action, and produce customer-focused solutions.
Effective time-management and organizational skills, including the ability to prioritize initiatives, align resources, articulate expectations, and motivate teams.
Adaptability and flexibility in response to change, with the ability to lead teams through change.
Ability to build professional partnerships, think strategically and critically, use data to inform decisions, and solve problems collaboratively.
Must be able to meet the job’s non-compete agreement requirement.

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 develop the Pharmacy Performance team, setting expectations and accountabilities, coaching employees, supporting development and performance improvement, facilitating change, and fostering a positive work environment.
Provide day-to-day management of financial and human resources, including coordination and budgeting for staff and department-specific functions and services.
Support business objectives and deliver results that meet business and stakeholder needs; identify, monitor, and communicate critical business metrics and use results to inform process improvements.
Serve as a 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 support customer and stakeholder service and company results.
Collaborate with the Pharmacy Product team to inform product strategy, contribute to roadmap planning, and provide subject matter expertise.
Ensure adherence to contractual, regulatory, and accreditation standards, including CMS, HEDIS, and NCQA, through oversight and documentation.
Represent non-clinical pharmacy perspectives in enterprise initiatives, cross-functional workgroups, and strategic planning efforts.
Promote accountability, innovation, and service excellence across the team.
Partner with internal stakeholders, including Compliance, Legal, Product, and Technology, to resolve issues promptly and align work with enterprise priorities.
Monitor and analyze performance metrics to identify trends, risks, and opportunities for improvement.
Contribute to developing and maintaining policies, procedures, and training materials for consistent and compliant execution.
Perform other duties as assigned.