Team Leader - Pharmacy Business Support (PBM Oversight)

Wellmark, Inc.•Des Moines, IA

8d•Hybrid

About The Position

The Team Leader of Pharmacy Business Support leads and develops a growing Pharmacy Performance team responsible for rigorous oversight of Wellmark’s Pharmacy Benefits Manager (PBM) and other pharmacy vendors. The role focuses on improving vendor oversight, identifying process gaps and risks, and using data and critical thinking to find efficiencies and trends. The Team Leader builds professional partnerships across the organization and with external partners, and influences others collaboratively. The position provides day-to-day leadership and management of financial and human resources, with emphasis on employee coaching, development, performance improvement, coordination, and budgeting. The leader sets expectations and accountabilities, facilitates change, and fosters a positive, accountable, innovative, and service-focused team environment. The role also supports business objectives, monitors key metrics, contributes to pharmacy product strategy, and represents non-clinical pharmacy perspectives in enterprise initiatives. 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 needed to meet business needs. 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 a combination of 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 varying audiences and vendor partners.
Understanding of applicable rules, regulations, and guidelines and their implications for the department.
Strong consulting and critical-thinking skills, including the ability to provide insights and recommendations, influence action, and develop 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.
Ability to build professional partnerships, think strategically, use data to inform decisions, and creatively solve problems.

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.

Responsibilities

Lead and develop the Pharmacy Performance team responsible for oversight of Wellmark’s PBM and other pharmacy vendors.
Manage financial and human resources, including employee coaching, development, performance improvement, coordination, and budgeting for staff and department functions.
Support business objectives and deliver 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 a primary liaison with CVS on 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 promote stakeholder service and company results.
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 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 and align work with enterprise priorities.
Analyze performance metrics to identify trends, risks, and improvement opportunities.
Contribute to policies, procedures, and training materials that support consistent and compliant execution.
Perform other duties as assigned.