TL;DR
Senior Director, Pharmacy and PBM Operations: Overseeing and managing Progyny’s pharmacy benefit management (PBM) program, driving operational excellence at both tactical and strategic levels with an accent on leading end-to-end PBM/pharmacy operational projects and integrating new programs. Focus on anticipating and navigating emerging changes in the healthcare landscape and identifying innovative solutions to complex challenges.
Location: Remote (USA), with salary specific to New York City based applicants.
Salary: $165,000–$195,000 annual.
Company
Progyny is a global leader in women’s health and family building solutions, empowering patients with concierge support and access to a premier network of fertility and women's health specialists.
What you will do
- Oversee and manage key PBM/pharmacy programs, providing operational leadership at both tactical and strategic levels.
- Develop, support, and execute end-to-end lifecycle of PBM/pharmacy-related operational projects and deliverables.
- Serve as the primary contact for PBM/pharmacy trading partners.
- Implement and enhance operational processes to improve efficiency, accuracy, and customer satisfaction.
- Collaborate with cross-functional teams for seamless integration of new programs and services.
- Monitor and analyze key performance indicators to identify areas for improvement and optimization.
Requirements
- 12+ years of extensive experience in PBM operations, including interaction with self-funded and employer-sponsored health plan benefits.
- Comprehensive knowledge of PBM/pharmacy/healthcare industry, third party administrators, benefit setup, pharmacy claims, and managed care.
- Strong understanding of PBM processes: claims adjudication, network development, pricing, analytics/reporting, rebates, clinical aspects, trade, contracting, systems, and account management.
- Experience negotiating contracts with PBMs and pharmacies.
- High proficiency in project management methodologies for effective planning, execution, and monitoring of key initiatives.
- Exceptional communication skills to convey complex PBM/pharmacy concepts to diverse stakeholders.
Nice to have
- Doctor of Pharmacy preferred.
- Knowledge of accreditation standards (URAC, ACHC).
Culture & Benefits
- Paid family and parental leave, preconception, fertility, and family building benefits.
- Health, dental, vision, and life insurance options for employees and family.
- Free in-person, virtual, and text-based mental health and wellness support.
- Paid time off, including vacation, sick leave, personal days, and summer flex time.
- 401(k) plan with company match and company equity with bonus program.
- Learning and development programs, including a mentorship program.