Vice President, General Manager

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

📋 Description

• Lead the vision, strategy, growth, and execution of Gainwell's Medicaid Pharmacy Administration and Technology portfolio.

• Provide executive leadership and strategic direction for the product portfolio related to Medicaid Pharmacy Administration and Technology.

• Oversee the strategy and implementation of enterprise pharmacy solutions, including claims processing, POS adjudication, clinical edits, prior authorization, DUR, PDLs, supplemental rebates, PBM capabilities, analytics, and interoperability initiatives.

• Collaborate with state Medicaid agencies, executive client leadership, pharmacy directors, CMS stakeholders, clinical teams, and technology organizations.

• Propel modernization through cloud transformation, automation, API-enabled interoperability, FHIR standards, data analytics, AI-driven decision support, and scalable product architecture.

• Direct the delivery and implementation of pharmacy administration solutions across various Medicaid clients.

• Act as the executive sponsor for strategic pharmacy initiatives spanning Product Management, Engineering, Clinical Services, Operations, Sales, Account Management, Implementation, and Government Relations.

• Manage P&L, investment strategy, revenue growth, margin enhancement, pricing strategy, and long-term planning for the Medicaid Pharmacy product portfolio.

• Create business cases for strategic investments, modernization, acquisitions, partnerships, and innovation initiatives, presenting recommendations to executive leadership and overseeing execution.

• Support new business initiatives, proposal development, executive presentations, solution strategy, and client demonstrations.

• Establish strategic partnerships with pharmacy technology vendors, clinical collaborators, industry organizations, and strategic alliances.

• Ensure adherence to Medicaid regulations, CMS guidelines, HIPAA, NCPDP standards, drug rebate requirements, pharmacy audit standards, and contractual commitments.

⛳️ Requirements

• A minimum of twenty years of progressive leadership experience in healthcare technology, Medicaid, pharmacy administration, pharmacy benefit management (PBM), healthcare SaaS, or health information systems.

• Proven executive experience in leading Medicaid Pharmacy Administration products, pharmacy claims systems, PBM platforms, pharmacy operations, or state Medicaid pharmacy technology solutions.

• Comprehensive knowledge of Medicaid pharmacy operations, including pharmacy claims adjudication, NCPDP standards, POS processing, rebates, prior authorization, drug utilization review (DUR), preferred drug lists (PDLs), pharmacy provider management, and pharmacy benefit administration.

• Strong grasp of federal and state Medicaid regulations, CMS guidance, managed care pharmacy, fee-for-service pharmacy programs, and pharmacy program integrity.

• Experience in defining enterprise product strategy, product lifecycle management, roadmap development, commercialization, and technology modernization within highly regulated healthcare settings.

• Background in leading digital transformation initiatives involving cloud technologies, APIs, interoperability, analytics, automation, and AI-enabled healthcare solutions.

• At least fifteen years of executive leadership experience managing large cross-functional organizations.

• Familiarity with Lean, Six Sigma, Agile product development, and continuous improvement methodologies.

• Experience in managing complex P&Ls, investment planning, business case development, pricing strategy, and financial performance for substantial healthcare technology portfolios.

• Demonstrated success in building executive relationships with state Medicaid agencies, healthcare executives, technology partners, and industry organizations.

🏝️ Benefits

• Work flexibility.

• Learning and career development opportunities.

• Generous, flexible vacation policy.

• 401(k) employer match.

• Comprehensive health benefits.

• Educational assistance.

• Leadership and technical development academies.