Pharmacy Manager – Service Delivery

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

📋 Description

• Lead comprehensive pharmacy testing throughout SIT, UAT, Regression, Parallel Testing, and Production Validation phases.

• Create and oversee the test strategy, plans, schedules, and governance for execution.

• Ensure alignment with business needs, CMS guidelines, and state Medicaid regulations.

• Supervise pharmacy functional validation, which includes claims adjudication, drug pricing, formulary management, prior authorization, rebates, NCPDP transactions, and financial reconciliation processes.

• Manage defects while coordinating with business SMEs, vendors, developers, conversion teams, and testing resources.

• Deliver leadership reporting and communicate with stakeholders by monitoring quality metrics, risks, issues, and test progress.

⛳️ Requirements

• Over 10 years of experience in software testing.

• More than 5 years of experience in Test Management.

• Strong experience in PBM or Medicaid pharmacy.

• Experience with large-scale DDI or MMIS modernization initiatives.

• Proven expertise in claims adjudication.

• Proficiency in NCPDP transactions.

• In-depth knowledge of prior authorization processes.

• Skilled in formulary management.

• Expertise in drug rebate processing.

• Familiarity with pharmacy financial validation.

• Experience utilizing ALM/JIRA and SQL for data validation.

🏝️ Benefits

• Flexible work options.

• Opportunities for learning and career advancement.

• Access to technical credentials and certifications.

• Generous and flexible vacation policy.

• Educational assistance provided.

• Comprehensive leadership and technical development academies.

• 401(k) employer matching.

• Extensive health benefits.

• Opportunities for occasional travel (0-10%).