Vice President, PBM Management
Confidential
Vice President, PBM Management
About the Company
Emerging health insurance company focused on elderly & low-income patients
Industry
Hospital & Health Care
Type
Public Company
Founded
2014
Employees
501-1000
Categories
- Health Care
- Health & Wellness
- Health Care Information Technology
- Health Insurance
- Insurance
- Hospital
- Medical
- Health and Insurance
Specialties
- medicare advantage
- engineers
- heathcare
- complex care
- home care
- start-ups
- artificial intelligence
- machine learning
- hedis
- stars
- and insurance
Business Classifications
- B2C
About the Role
The Company is seeking a Vice President of PBM Management to spearhead the development and execution of the pharmacy strategy for its Medicare Advantage plans. This executive will be responsible for all aspects of the pharmacy strategy, including the management of the PBM partnership, contractual obligations, formulary strategy, and overall financial performance. The role demands a leader who can ensure that pharmacy and PBM management are not just cost centers, but are, in fact, a competitive advantage. The successful candidate will work closely with the CEO of the Medicare Advantage business to shape enterprise strategy and will be expected to build and lead a high-performing team to optimize PBM performance and financial outcomes. Candidates for this role should have a proven track record in leading pharmacy strategy within a Medicare Advantage plan or a similarly complex payer environment. Deep experience in managing PBMs and pharmacy vendors, as well as a strong understanding of formulary management, PBM contract enforcement, CMS regulations, and pharmacy economics, is essential. The ideal candidate will be adept at balancing clinical quality, member experience, and financial performance, and will be comfortable influencing executives while also being detail-oriented in contract negotiation and enforcement. The role requires a strategic thinker who can continuously identify opportunities to enhance the quality, affordability, and financial performance of PBM contracts.
Hiring Manager Title
CEO
Functions
- Operations
- Strategy
- Finance
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- ...Vice President of Program Management About the Company Lean, fast-paced biotech advancing late-stage clinical programs toward registration and commercialization. Industry Biotechnology Type Privately Held, VC-backed About the Role The Company is...
- ...Vice President of Product Management About the Company Online sampling marketplace catering to beauty products Industry Information Technology and Services Type Privately Held, VC-backed Founded 2011 Employees 201-500 Funding $200+ million...
- ...Vice President of Product Management, Payments & Money Movement About the Company Innovative electronic payment transaction network Industry Financial Services Type Privately Held Founded 2009 Employees 201-500 Funding $51-$75 million...
- ...Vice President, Global Alliance Management About the Company A global leader in generic pharmaceuticals improving access to affordable medicines worldwide. Industry Pharmaceuticals Type Privately Held, Private Equity-backed About the Role The Company...Worldwide
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- ...Vice President of Revenue Cycle Management About the Company Enterprise leadership of revenue cycle operations across a complex healthcare organization. Industry Hospital & Health Care Type Privately Held About the Role The Company is seeking a...
- ...Vice President of Program Management About the Company A lean, fast-paced biotech company advancing late-stage immunology programs. Industry Biotechnology Type Privately Held About the Role The Company is seeking a Vice President of Program Management...
- ...Our client is seeking a Vice President of Accounting to lead the accounting function for a growing, private equity-backed oil & gas organization... ...standards. Support budgeting, forecasting, cash flow management, and financial analysis in partnership with the finance team....
- ...Senior Vice President of Finance Department: Blue Mantis Employment Type: Full Time Location: Onsite Description The Senior Vice President... ...and company policies. Treasury, Risk & Governance Lead cash management, liquidity planning, and working capital optimization efforts...Full timeContract workWork at officeRemote work
- ...ApartmentRatings and SatisFacts Research is seeking a Regional Vice President of Sales for our Northeast territory (ME, NH, VT, NY, MA, CT,... ...or more years of multifamily vendor sales experience in managing sales in a corporate setting Proven record of success with the...Temporary workFlexible hours
- ...Our client is looking for a Vice President of Operatons. Lead the implementation of operational strategies and objectives across multiple revenue generating departments. Understand each product and manage improvement of operational efficiency. Exceed the product delivery...
- ...The Regional Vice President (RVP) at Acumen Financial Advantage (AFA) is responsible for driving new and recurrent business growth by securing... ..., educational institutions, and nonprofits. The RVP will manage a geographic territory, cultivate assigned Channel Partner relationships...Work at office
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$285k - $385k
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- ...Vice President of Global Customer Support About the Company Top cloud-based legal software provider Industry Computer Software... ...& Professional Services Legal Assistance Client Management Billing Management Document Automation CRM Solutions...WorldwideShift work
- ...Vice President, Government Partnerships About the Company Innovative provider of safety-focused AI technology for healthcare applications... ...of activities, including business development, relationship management with government stakeholders and prime contractor partners,...For contractors
- ...Vice President, AI Strategy & Transformation About the Company Leading global biopharmaceutical company developing and commercializing... ...fast-paced, regulated environment and deliver against timelines. Functions Strategy Data Management/Analytics Confidential
$100k
...Vice President of Sales, Regional About the Company Innovative provider of smart parking solutions Industry Information Technology... ...at forecasting, have a disciplined approach to pipeline management, and be experienced in using AI in the sales process. While not...
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