Pharmacy Program Manager

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

📋 Description

• Assist in daily administrative and operational functions of the PBM team, encompassing scheduling, meeting organization, documentation, correspondence, and monitoring of key initiatives and deliverables.

• Organize and facilitate PBM leadership meetings, executive sessions, vendor discussions, and other pharmacy-related meetings and initiatives.

• Act as a liaison between the PBM team, senior leadership, vendors, and cross-functional departments to ensure timely communication, issue resolution, and the execution of pharmacy initiatives.

• Support health plan pharmacy operations and collaborate with vendors to ensure that operational processes and services align with the approved benefit design, formulary strategy, and business requirements.

• Assist in the implementation and maintenance of formularies, involving updates, drug file reviews, benefit configuration coordination, and related operational activities.

• Help prepare and coordinate materials for Pharmacy & Therapeutics (P&T) Committee meetings, including agendas, drug evaluations, documentation, and follow-up actions.

• Review and maintain prior authorization (PA) guidelines, pharmacy FAQs, education materials for members and providers, and other pharmacy-related communications.

• Work with PBM leadership and key stakeholders to communicate pharmacy strategies, clinical programs, benefit modifications, and other pharmacy initiatives throughout the organization.

• Create and coordinate training and educational materials for Member Services, Account Management, Sales, Operations, and other relevant teams.

• Assist the Director of Pharmacy Networks with pharmacy network-related initiatives and activities.

• Maintain and update monthly pharmacy network files and associated documentation.

• Review and analyze network reports, audits, and identified issues, coordinating appropriate follow-up actions.

• Support monitoring, maintenance, and issue resolution activities related to the pharmacy network.

• Assist with direct pharmacy contracting initiatives and the associated documentation and follow-up.

• Support pharmacy network projects, operational needs, and other assigned initiatives.

• Track pharmacy projects, action items, deadlines, and deliverables to ensure timely execution and accountability.

• Identify opportunities to enhance pharmacy processes, workflows, communications, and operational efficiency.

• Assist with vendor management activities, including the coordination of deliverables, issue tracking, documentation, and follow-up.

• Maintain proper documentation and records related to pharmacy programs, operations, vendors, and regulatory requirements.

• Provide support for other pharmacy and health plan operational initiatives as necessary.

⛳️ Requirements

• Bachelor’s degree is required.

• An active Pharmacy Technician license from the applicable PTCB is mandatory.

• A minimum of 3 years of experience in healthcare, managed care, PBM, pharmacy operations, or a related field is essential.

• Strong organizational and project management skills, with the capability to manage multiple priorities, deadlines, and projects with high accuracy and attention to detail.

• Excellent written and verbal communication abilities, enabling effective interaction with senior leadership, vendors, and cross-functional teams.

• Familiarity with pharmacy benefits, claims processing, pharmacy operations, and prescription drug terminology is necessary.

• Proven ability to proactively identify issues, utilize sound judgment, and formulate practical solutions in a fast-paced environment.

• Highly resourceful and collaborative, with the ability to work independently and effectively across multiple departments and external business partners.

• Capacity to handle confidential information with discretion and adapt to changing priorities.

• Proficient in Google Suite, Microsoft Office (Outlook, Word, Excel, and PowerPoint), Adobe Acrobat, and Video Conference Software (Zoom, Google Meets, WebEx, Teams, etc.).

• Project Management certification is preferred.

🏝️ Benefits

• Curative Health Plan (100% employer-covered medical premiums for you and 50% coverage for dependents on the base plan.)

• $0 copays and $0 deductibles (with completion of our Baseline Visit)

• Preventive and primary care included

• Mental health support (Rula, Televero, Two Chairs, Recovery Unplugged)

• One-on-one care navigation

• Chronic condition programs (diabetes, weight, hypertension)

• Maternity and family planning assistance

• 24/7/365 Curative Telehealth

• Pharmacy benefits

• Comprehensive dental and vision coverage

• Employer-provided life and disability coverage with additional supplemental options

• Flexible spending accounts

• Generous PTO policy plus 11 paid annual company holidays

• 401K for full-time employees

• Generous up to 8–12 weeks paid parental leave, based on role eligibility.