Manager, Pharmacy Operations at Bright Health

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ABOUT THE ROLE

The Senior Manager, Pharmacy Operations will assist in managing the PBM relationship, with a focus on all non-clinical PBM deliverables. This position will also develop an oversight structure to be implemented for the PBM and all pharmacy vendors. This oversight structure will include the establishment of KPI’s and program dashboards to measure PBM performance.

YOUR RESPONSIBILITIES

  • Assist in managing the PBM relationship for Bright and Brand-New Day, with a focus on all non-clinical PBM deliverables
  • Develop oversight structure to be implemented for the PBM(s) and all pharmacy vendors
  • Develop project plans and manage various stakeholders to ensure accurate and timely implementation of projects within the PBM
  • Define and document corporate oversight processes for all delegated pharmacy functions
  • Draft and maintain administrative pharmacy polices
  • Establish KPIs and Program dashboards to measure PBM performance
  • Manage PBM to maintain or exceed KPIs and Performance Guarantees
  • Present PBM performance dashboards to senior leaders of Bright Health
  • Oversee the pharmacy benefit and formulary administration within the PBM
  • Collaboratively work with both clinical and non-clinical areas within Bright
  • Present dashboards to senior leaders of Bright
  • Support end-to-end benefit build and testing of new implementations, and readiness activity (inclusive of clinical and benefit setup)
  • Help prepare and disseminate reporting including compliance, PBM oversight, financial, plan performance, claims payment and accuracy, utilization management, customer service, rebates, and operational performance
  • Support claims platform or PBM transitions as they come up in the usual course of business, this entails business requirements, benefit build, testing, and oversight of benefit install

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • Bachelor’s in Science Degree required, Doctor of Pharmacy Degree preferred
  • Ten (10) years of professional experience in a PBM or Pharmacy health plan experience
  • Seven (7) years of project management/relationship management experience required, preferably in the pharmacy or healthcare industry
  • Six-Sigma Certification preferred

PROFESSIONAL COMPETENCIES

  • Strong analytic and critical thinking to resolve issues in a variety of complex situations requiring design of oversight processes which are lean, repeatable and complete
  • 100% team player
  • Exception attention to detail
  • Able to multi-task and set priorities with strong organization and problem-solving skills supporting and enabling sound decision-making
  • Excellent customer service and communication skills
  • Excellent written and verbal communication skills; ability to provide clear and concise information to senior leaders
  • Comfortable following timeline driven workplans and managing multiple projects; thrive in collaborative environments 

ABOUT US
 
At Bright Health, we brought together the brightest minds from the health care industry and consumer technology and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities we are reshaping how people and physicians achieve better health together.
 
We’re Making Healthcare Right. Together. 

We've won some fun awards like: Great Places to Work, Modern Healthcare, Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our growing team!
 
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

BRIGHT ON!

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Technology we use

  • Engineering
  • Product
  • Sales & Marketing
    • .NETLanguages
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    • PythonLanguages
    • ScalaLanguages
    • SqlLanguages
    • PowerShellLanguages
    • D3JSLibraries
    • ReactLibraries
    • ReduxLibraries
    • FlutterLibraries
    • ExpressFrameworks
    • Node.jsFrameworks
    • MongoDBDatabases
    • MySQLDatabases
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    • InVisionDesign
    • SketchDesign
    • Lucid ChartDesign
    • Aha!Management
    • ConfluenceManagement
    • JIRAManagement
    • Microsoft ProjectManagement
    • Microsoft DynamicsCRM

Location

We are downtown at 515 Congress Avenue, right in the heart of downtown! Tons of restaurants and close to public transportation.
Making Healthcare Better For All At Bright Health
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An Insider's view of Bright Health

What’s the vibe like in the office?

The office has a relaxed and laid back vibe but people are very serious about their work - perfect!

Anthony

Data Engineer

What does your typical day look like?

My day is so varied, given how quickly we're growing, which is fulfilling for me. I have a good balance of strategic and tactical work in my day as well as time to focus and time to collaborate.

Jen

VP, Digital

What makes someone successful on your team?

A hard-working team player who thinks first and codes next is likely to learn a lot and quickly become a valuable member of the team. Lots of experience with some of our tooling is always nice, but if someone can't knowledge-share well or responds poorly to code reviews and other requests for collaboration, it'll be a tough fit.

Brian

Software Engineer 3

How do your team's ideas influence the company's direction?

We hire smart individuals who thrive on accomplishment and purpose. Our teams are exposed to the bigger picture through constant communication and dialogues – that encourages them to come up with innovative solutions to problems. We've made significant adjustments on our direction in technology and process that were initiated by the team.

Abdullah

VP, Engineering

What are Bright Health Perks + Benefits

Bright Health Benefits Overview

We have 3 different health insurance plans, all through Cigna (HDP, Premium HDP and PPO). We cover the majority of the cost for the employee and some cost for family. We have two dental plans and a vision plan as well. We have a Lifestyle Spending Account and options for HSA/FSA. We put 3% of your total earnings into your 401K plan and you are immediately vested. We have all the latest technology (Mac or Surface laptops – your choice) to use including standing desks. Fully stocked fridge with snacks and drinks.

Culture
Partners with Nonprofits
Friends outside of work
Eat lunch together
Daily sync
Open door policy
Team owned deliverables
Team based strategic planning
Group brainstorming sessions
Pair programming
Open office floor plan
Diversity
Dedicated Diversity/Inclusion Staff
Unconscious bias training
Someone's primary function is managing the company’s diversity and inclusion initiatives
Mean gender pay gap below 10%
Hiring Practices that Promote Diversity
Health Insurance & Wellness Benefits
Flexible Spending Account (FSA)
Bright Health employees can contribute up to $3500 annually to their FSA.
Disability Insurance
Dental Benefits
Vision Benefits
Health Insurance Benefits
Life Insurance
Wellness Programs
Bright Health is proud to offer a wellness stipend of $200/month to all employees!
Onsite Gym
Mental Health Benefits
Retirement & Stock Options Benefits
401(K)
We will put 3% of your total earnings into your 401K plan, even if you don't put anything in. It's a safe harbor contribution.
401(K) Matching
Bright Health provides employees with a 401(k) plan managed by Vanguard. We provide a ‘safe harbor’ non-elective contribution equal to 3% of your compensation, regardless of participation in the p
Performance Bonus
Child Care & Parental Leave Benefits
Generous Parental Leave
We provide up to 6 weeks of parental leave for the primary caretaker. We also provide 2 weeks of leave for the secondary caretaker.
Flexible Work Schedule
Bright Health provides employees with a flexible work schedule that includes Core hours, Flexible start and end times.
Remote Work Program
Family Medical Leave
Company sponsored family events
Bright Health sponsors family oriented events Annually.
Vacation & Time Off Benefits
Generous PTO
Paid Holidays
Paid Sick Days
Perks & Discounts
Casual Dress
Commuter Benefits
Stocked Kitchen
Happy Hours
Happy hours are hosted on occasion.
Relocation Assistance
Fitness Subsidies
Bright Health employees are eligible for discounts on several gym memberships.
Home Office Stipend for Remote Employees
Professional Development Benefits
Diversity Program
Lunch and learns
Cross functional training encouraged
Promote from within
Online course subscriptions available
Customized development tracks

Additional Perks + Benefits

Bright's primary goal is to offer employee benefits and perks that are as flexible as possible to meet each employee's unique needs!

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