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!