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
Vacancy posted 3 days ago
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