Pharmacy Program Manager
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Job Description
Administrative Pharmacy Program Manager supporting Curative’s employer-based health insurance PBM operations. Coordinating formulary, pharmacy network, vendor, and P&T Committee initiatives.
Responsibilities:
- Support the day-to-day administrative and operational activities of the PBM team, including scheduling, meeting coordination, documentation, correspondence, and tracking of key initiatives and deliverables.
- Coordinate and support PBM leadership meetings, executive meetings, vendor meetings, and other pharmacy-related meetings and initiatives.
- Serve as a liaison between the PBM team, senior leadership, vendors, and cross-functional departments to facilitate timely communication, issue resolution, and execution of pharmacy initiatives.
- Support health plan pharmacy operations and coordinate with vendors to ensure operational processes and services align with approved benefit design, formulary strategy, and business requirements.
- Support formulary implementation and maintenance activities, including formulary updates, drug file reviews, benefit configuration coordination, and related operational activities.
- Assist with preparation and coordination of Pharmacy & Therapeutics (P&T) Committee materials, meeting agendas, drug reviews, documentation, and follow-up activities.
- Review, maintain, and coordinate updates to prior authorization (PA) guidelines, pharmacy FAQs, member and provider education materials, and other pharmacy-related communications.
- Collaborate with PBM leadership and key stakeholders to communicate pharmacy strategies, clinical programs, benefit changes, and other pharmacy initiatives across the organization.
- Develop and coordinate training and educational materials for Member Services, Account Management, Sales, Operations, and other teams as appropriate.
- Assist the Director of Pharmacy Networks with pharmacy network-related activities and initiatives.
- Maintain and update monthly pharmacy network files and related documentation.
- Review and analyze network reports, audits, and identified issues and coordinate appropriate follow-up.
- Support pharmacy network monitoring, maintenance, and issue resolution activities.
- Assist with direct pharmacy contracting initiatives and related documentation and follow-up.
- Support pharmacy network projects, operational needs, and other initiatives as assigned.
- Track pharmacy projects, action items, deadlines, and deliverables to support timely execution and accountability.
- Identify opportunities to improve pharmacy processes, workflows, communications, and operational efficiency.
- Support vendor management activities, including coordination of deliverables, issue tracking, documentation, and follow-up.
- Maintain appropriate documentation and records related to pharmacy programs, operations, vendors, and regulatory requirements.
- Support other Pharmacy and health plan operational initiatives as needed.
Requirements:
- Bachelor’s degree required
- Must possess an active Pharmacy Technician license in the applicable PTCB
- 3+ years of experience in healthcare, managed care, PBM, pharmacy operations, or a related field.
- Strong organizational and project management skills, with the ability to manage multiple priorities, deadlines, and projects with a high degree of accuracy and attention to detail.
- Excellent written and verbal communication skills, with the ability to effectively communicate with senior leadership, vendors, and cross-functional teams.
- Working knowledge of pharmacy benefits, claims processing, pharmacy operations, and prescription drug terminology.
- Demonstrated ability to proactively identify issues, exercise sound judgment, and develop 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.
- Ability 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 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 built in
- Mental health support (Rula, Televero, Two Chairs, Recovery Unplugged)
- One-on-one care navigation
- Chronic condition programs (diabetes, weight, hypertension)
- Maternity and family planning support
- 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.
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