Director, Pharmacy Operations Strategy & Integration
Core
Shape and execute Oscar's pharmacy operational excellence agenda, translating strategic priorities into operating-model improvements, cross-functional programs, and scalable workflows to advance affordability and member/provider experience.
Role type
Director, Strategy & Operations (Healthcare/Payer)
Builds
Pharmacy operating model, cross-functional programs, vendor capabilities, and scalable workflows
Domain
Health Insurance / Pharmacy Benefit Management (PBM) / Managed Care
Required skills
Strategic planning, operational transformation, cross-functional leadership, regulatory compliance interpretation, budget management, change management, data synthesis for executive reporting, vendor management, process engineering
Preferred skills
MBA/MPH, Management consulting, Lean/Six Sigma, PBM implementation, claims adjudication, formulary operations, prior authorization systems
Technologies
PBM systems, claims adjudication platforms, formulary management tools, rebate systems, healthcare data feeds
Responsibilities
Set pharmacy operational excellence strategy and execution model; Lead high-priority operational transformation initiatives from strategy to adoption; Partner with internal teams and external vendors to translate needs into measurable outcomes; Interpret regulatory requirements and communicate them to partners; Maintain deep understanding of payer economics and pharmacy ecosystem; Coordinate cross-functionally to align decision rights and delivery plans; Diagnose process friction points and design end-to-end solutions; Lead governance and executive reporting; Manage implementation risks and change management; Build repeatable operating playbooks and process standards; Support capacity planning and business-case development.
Seniority
Director, strategic leadership with hands-on execution