Director, Pharmacy Operations Strategy – Integration

This is a fully remote position, open to applicants in United States.

📋 Description

• Establish the strategy for pharmacy operational excellence, including the operating rhythm and execution model.

• Spearhead high-impact pharmacy operational transformation projects from conception to implementation, covering opportunity identification, roadmap creation, operational readiness, launch planning, and ongoing adoption.

• Convert pharmacy and PBM opportunities, as well as member and provider needs and frontline insights, into prioritized actions, decisions, and measurable outcomes.

• Analyze PBM, pharmacy benefit, managed care, and healthcare regulatory requirements, and effectively communicate these to stakeholders.

• Collaborate with internal teams and external vendors on execution plans, business reviews, strategic discussions, issue escalation, performance tracking, and operational integration.

• Coordinate efforts across Clinical, Pharmacy Operations, Product, Engineering, Finance, Actuarial, Concierge, Compliance, and vendor partners.

• Identify process, data, technology, and vendor friction points and create comprehensive solutions.

• Enhance member and provider experiences throughout pharmacy journeys.

• Oversee governance and executive reporting for pharmacy operational excellence projects.

• Manage risks, dependencies, decisions, and change-management requirements related to implementations.

• Develop operational playbooks, process standards, controls, and best practices for a scalable PBM operating model.

• Tackle complex issues and lead technology-driven process improvements and operational transformations.

• Assist with capacity planning, budget oversight, business case development, and measuring value realization.

• Ensure that workflows, vendor capabilities, and program execution align with regulatory, compliance, quality, and contractual obligations.

• Adhere to relevant laws and regulations while performing additional duties as assigned.

⛳️ Requirements

• Over 10 years of experience in healthcare, business operations, strategy and operations, product operations, or program leadership.

• More than 7 years of experience in Managed Care, PBM, pharmacy operations, clinical operations, or other related healthcare payer roles.

• At least 5 years of experience leading large-scale, cross-functional strategy, operational transformation, or implementation projects from opportunity identification to launch and adoption.

• Minimum of 5 years working directly with cross-functional business, Product, Engineering, vendor, or operations teams to establish priorities, define requirements, influence solutions, and achieve business outcomes.

• Proficient in interpreting regulatory, compliance, operational, or contractual business needs and converting them into actionable requirements.

• Experienced in strategic planning, roadmapping, business analysis, operational readiness, change management, and creating executable cross-functional plans.

• Skilled in translating complex operational data and performance metrics into executive-level insights, recommendations, and governance documentation.

• Experience managing budgets, capacity models, business cases, or financial performance for operational or transformation initiatives.

• Background in management consulting, internal strategy and operations, process engineering, Lean, Six Sigma, or similar structured problem-solving methodologies.

• Familiarity with PBM implementation, pharmacy benefit administration, claims adjudication, formulary operations, prior authorization, rebate/formulary systems, or healthcare data feeds.

• Proven ability to work in matrixed teams during enterprise transformation, implementation, or operational excellence initiatives.

🏝️ Benefits

• Employee benefits.

• Unlimited vacation program.

• Company equity grants.

• Annual performance bonuses.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 11 paid holidays.

• Paid sick leave.

• Paid parental leave.

• Participation in 401(k) plan.

• Life insurance.

• Disability insurance.

• Paid wellness time and reimbursements.