Pharmacy Operations Manager - Remote

Overview

The Pharmacy Operations Manager plays a pivotal role in providing operational and clinical support for pharmacy benefits across sales, account management, and plan sponsor functions.

In Short

• Manage end-to-end Pharmacy Benefit Manager (PBM) implementations.
• Ensure timely and accurate claim adjudication.
• Serve as the primary liaison between the Health Plan and PBM partners.
• Support enterprise-wide pharmacy installations and Medicare compliance efforts.
• Educate internal stakeholders on pharmacy benefit structures.
• Lead the setup of pharmacy benefits for new accounts.
• Generate pharmacy reports using PBM reporting platforms.
• Troubleshoot claim adjudication and benefit configuration issues.
• Maintain operational SLAs and quality benchmarks.
• Provide expert support on Medicare-related inquiries.

Requirements

• Bachelor’s degree in Pharmacy, Business Administration, or related field.
• Minimum of 5 years of experience in pharmacy benefits management.
• Experience working with PBM vendors.
• Strong analytical skills and data-driven decision-making experience.
• Knowledge of federal and state regulatory requirements.
• Proficiency in Microsoft Office Suite and PBM-related software.

Benefits

• Dental and Vision coverage.
• STD and/or LTD insurance.
• Voluntary Life & AD&D insurance.
• Accident and Critical Illness insurance.
• Health Advocate EAP.
• Health Equity Commuter Benefits.
• ZayZoon services.
• 401k plan.