Pharmacy Programs Manager
Core
Oversees pharmacy networks and manages operations with external pharmacy benefit managers (PBMs) across Medicare plans, ensuring pricing accuracy, operational quality, and regulatory compliance.
Role type
Senior IC pharmacy programs manager
Builds
Pharmacy benefit network operations and PBM vendor performance
Domain
Healthcare / Insurance / Medicare
Required skills
Pharmacy network management, PBM vendor management, claims research, benefit design implementation, regulatory compliance (Medicare/Medicaid), project management, database management
Preferred skills
None stated
Technologies
None stated
Responsibilities
Monitor network pharmacies for pricing setup accuracy, drive PBM vendor performance through claims research and testing, oversee PBM mail order and customer service functions, ensure compliance with Medicare/Medicaid standards
Seniority
Senior, hands-on IC