- Support the day-to-day administrative and operational activities of the PBM team, including scheduling, meeting coordination, documentation, correspondence, and tracking of key initiatives and deliverables.
- Coordinate and support PBM leadership meetings, executive meetings, vendor meetings, and other pharmacy-related meetings and initiatives.
- Serve as a liaison between the PBM team, senior leadership, vendors, and cross-functional departments to facilitate timely communication, issue resolution, and execution of pharmacy initiatives.
- Support health plan pharmacy operations and coordinate with vendors to ensure operational processes and services align with approved benefit design, formulary strategy, and business requirements.
- Support formulary implementation and maintenance activities, including formulary updates, drug file reviews, benefit configuration coordination, and related operational activities.
- Assist with preparation and coordination of Pharmacy & Therapeutics (P&T) Committee materials, meeting agendas, drug reviews, documentation, and follow-up activities.
- Review, maintain, and coordinate updates to prior authorization (PA) guidelines, pharmacy FAQs, member and provider education materials, and other pharmacy-related communications.
- Collaborate with PBM leadership and key stakeholders to communicate pharmacy strategies, clinical programs, benefit changes, and other pharmacy initiatives across the organization.
- Develop and coordinate training and educational materials for Member Services, Account Management, Sales, Operations, and other teams as appropriate.
- Assist the Director of Pharmacy Networks with pharmacy network-related activities and initiatives.
- Maintain and update monthly pharmacy network files and related documentation.
- Review and analyze network reports, audits, and identified issues and coordinate appropriate follow-up.
- Support pharmacy network monitoring, maintenance, and issue resolution activities.
- Assist with direct pharmacy contracting initiatives and related documentation and follow-up.
- Support pharmacy network projects, operational needs, and other initiatives as assigned.
- Track pharmacy projects, action items, deadlines, and deliverables to support timely execution and accountability.
- Identify opportunities to improve pharmacy processes, workflows, communications, and operational efficiency.
- Support vendor management activities, including coordination of deliverables, issue tracking, documentation, and follow-up.
- Maintain appropriate documentation and records related to pharmacy programs, operations, vendors, and regulatory requirements.
- Support other Pharmacy and health plan operational initiatives as needed.
Requirements
- Bachelor’s degree required
- Must possess an active Pharmacy Technician license in the applicable PTCB
- 3+ years of experience in healthcare, managed care, PBM, pharmacy operations, or a related field.
- Strong organizational and project management skills, with the ability to manage multiple priorities, deadlines, and projects with a high degree of accuracy and attention to detail.
- Excellent written and verbal communication skills, with the ability to effectively communicate with senior leadership, vendors, and cross-functional teams.
- Working knowledge of pharmacy benefits, claims processing, pharmacy operations, and prescription drug terminology.
- Demonstrated ability to proactively identify issues, exercise sound judgment, and develop practical solutions in a fast-paced environment.
- Highly resourceful and collaborative, with the ability to work independently and effectively across multiple departments and external business partners.
- Ability to handle confidential information with discretion and adapt to changing priorities.
- Proficient in Google Suite, Microsoft Office (Outlook, Word, Excel, and PowerPoint), Adobe Acrobat, and Video Conference Software (Zoom, Google Meets, WebEx, Teams, etc.)
- Project Management certification preferred
Core Competencies
Demonstrates expertise in pharmacy operations, project management, and effective communication with cross-functional teams. Proficient in managing multiple priorities while ensuring compliance with pharmacy benefit design and operational processes.
Highest-signal resume keywords
- Pharmacy Technician License
- Healthcare Experience
- Project Management Skills
- Pharmacy Benefits Knowledge
- Vendor Management
ATS Optimization Keywords
Hard Skills
- Pharmacy Operations
- Claims Processing
- Formulary Management
- Prior Authorization Guidelines
- Documentation Coordination
- Operational Efficiency Improvement
- Drug File Reviews
- Pharmacy Network Monitoring
- Issue Resolution
- Training Material Development
Soft Skills
- Organizational Skills
- Attention to Detail
- Communication Skills
- Collaboration
- Problem-Solving
Certifications & Qualifications
- Project Management Certification
- Active Pharmacy Technician License
Industry Keywords
- Pharmacy Benefit Manager (PBM)
- Managed Care
- Healthcare
- Pharmacy & Therapeutics (P&T) Committee
- Operational Processes
Tools & Technologies
- Google Suite
- Microsoft Office
- Adobe Acrobat
- Video Conference Software
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Pharmacy Program Manager Arbeitgeber: Jobtailor
Als Front Office Supervisor in unserem dynamischen Team bieten wir Ihnen die Möglichkeit, in einem unterstützenden und freundlichen Arbeitsumfeld zu wachsen. Wir legen großen Wert auf die berufliche Entwicklung unserer Mitarbeiter und bieten regelmäßige Schulungen sowie die Chance, Verantwortung zu übernehmen. Unsere Lage ermöglicht es Ihnen, Teil einer lebendigen Gemeinschaft zu sein, während Sie gleichzeitig die Standards unseres Franchise-Partners einhalten und unseren Gästen einen unvergesslichen Aufenthalt bieten.
