Director of Operations, PBM

Vaco
$130,000.00 - $150,000.00 / yr
United States, Indiana, Crown Point
Jan 08, 2025
The Director will ensure the PBM aligns with our strategic goals of improving patient outcomes, optimizing cost management, and enhancing overall service quality. Key Responsibilities: Strategic Leadership: Lead the creation of Pharmacy Benefit Manager, from conceptualization through full operational launch, driving the overall strategy, vision, and execution. Vendor Transition Management: Oversee the transition away from existing external PBM vendors (e.g., Optum) and ensure a seamless and cost-effective shift to in-house management. Operational Development: Design and develop core PBM functions, including claims processing, pharmacy network development, formulary development & management, drug utilization review, prior authorization review, P&T coordination, and specialty pharmacy services. Financial Oversight: Establish pricing strategies, rebate programs, and pharmacy network contracts to maximize cost savings while maintaining high-quality care. Regulatory Compliance: Ensure PBM operations adhere to all regulatory requirements, including state and federal healthcare laws, and oversee all reporting and auditing functions. Partnership & Collaboration: Build and maintain strong relationships with internal stakeholders, pharmaceutical companies, and pharmacy networks to ensure the success of the PBM. Team Leadership: Recruit, mentor, and manage a high-performing team capable of delivering on the operational and financial goals of the PBM. Continuous Improvement: Identify and implement best practices and innovative solutions to improve PBM service delivery, reduce costs, and enhance member satisfaction. Qualifications: Bachelor's degree in business, healthcare administration, pharmacy, or a related field (MBA or advanced degree preferred). 10+ years of experience in pharmacy benefit management, healthcare operations, or a related industry. Proven leadership experience in building or managing a PBM or pharmacy operations. Strong knowledge of PBM business models, rebate structures, formularies, and cost management strategies. Excellent understanding of healthcare regulatory compliance and pharmacy laws. Strong financial acumen with the ability to develop pricing strategies and manage P&L. Demonstrated ability to lead cross-functional teams and drive large-scale initiatives. Excellent communication, negotiation, and relationship-building skills. Must have at least 5 years of Medicare Part D experience. Vaco values a diverse workplace and strongly encourages women, people of color, LGBTQ+ individuals, people with disabilities, members of ethnic minorities, foreign-born residents, and veterans to apply. EEO Notice Vaco is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race (including but not limited to traits historically associated with race such as hair texture and hair style), color, sex (includes pregnancy or related conditions), religion or creed, national origin, citizenship, age, disability, status as a veteran, union membership, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, political affiliation, or any other protected characteristics as required by federal, state or local law. Vaco LLC and its parents, affiliates, and subsidiaries are committed to the full inclusion of all qualified individuals. As part of this commitment, Vaco LLC and its parents, affiliates, and subsidiaries will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact HR@vaco.com . Vaco also wants all applicants to know their rights that workplace discrimination is illegal. By submitting to this position, you agree that you will be giving Vaco the exclusive right to present your as a candidate for the foregoing employment opportunity. You further agree that you have represented information about yourself accurately and have not affirmatively misrepresented your qualifications. You also agree to maintain as confidential, to the fullest extent permitted by law, any information you learn from Vaco about the position and you will limit disclosure of information about the position only to the extent necessary to perform any obligations in furtherance of your application. In exchange, Vaco agrees to exercise reasonable efforts to represent you through all solicitation, job screening and resume dispersal. Privacy Notice Vaco LLC and its parents, affiliates, and subsidiaries ("we," "our," or "Vaco") respects your privacy and are committed to providing transparent notice of our policies. California residents may access Vaco's HR Notice at Collection for California Applicants and Employees here. Virginia residents may access our state specific policies here. Residents of all other states may access our policies here. Canadian residents may access our policies in English here and in French here. Residents of countries governed by GDPR may access our policies here. Pay Transparency Notice Determining compensation for this role (and others) at Vaco depends upon a wide array of factors including but not limited to: the individual's skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs. With that said, as required by local law, Vaco believes that the following salary range referenced above reasonably estimates the base compensation for an individual hired into this position in geographies that require salary range disclosure. The individual may also be eligible for discretionary bonuses.