Director of Pharmacy Operations & PBM Transformation

The Briefed; Dallas (TX); On-site; USD 162,000 - 213,000; Full time

Benefits offered by this job

Unlimited vacation

11 paid holidays

Health/dental/vision insurance

401(k) with match

Job summary

Oscar Health seeks a Director of Pharmacy Operations Strategy & Integration to shape and execute the pharmacy operating model across Clinical Strategy and Operations. You will bridge Pharmacy, Clinical, Product, Engineering, Finance, Actuarial, and PBM/vendor partners to deliver scalable workflows and affordability initiatives.

With 10+ years in healthcare operations and 7+ years in PBM or pharmacy contexts, you will own high-impact programs, develop business cases, and drive value realization

Qualifications

• 10+ years of progressive experience in healthcare, operations, strategy, or program leadership.
• 7+ years in Managed Care, PBM, pharmacy operations, or healthcare payer environments.
• 5+ years leading large-scale cross-functional strategy and transformation initiatives.
• 5+ years partnering with cross-functional teams to deliver outcomes.
• Data and regulatory fluency translating requirements into operational specs.

Responsibilities

• Set the operational excellence agenda and execution model for Pharmacy.
• Lead end-to-end pharmacy operational transformation initiatives from concept to adoption.
• Coordinate with Product, Engineering, Finance, Actuarial, Concierge, Legal, and PBM/vendor partners.
• Apply expertise in managed care, payer economics, and formulary operations to streamline processes.
• Translate regulations into actionable workflows and controls.
• Diagnose bottlenecks and design scalable solutions to improve throughput and affordability.
• Synthesize data into executive briefs and manage budgets and ROI metrics.
• Create repeatable playbooks, SOPs, and controls to support a scalable PBM model.

Skills

Pharmacy operations

Cross-functional leadership

PBM integration

Regulatory compliance

Executive reporting

Budget & ROI

Education

MBA

MPH

Tools

PBM implementations

Claims adjudication engines

Prior authorization software

Healthcare data feeds

Job description

Oscar Health seeks a Director of Pharmacy Operations Strategy & Integration to shape and execute the pharmacy operating model across Clinical Strategy and Operations. You will bridge Pharmacy, Clinical, Product, Engineering, Finance, Actuarial, and PBM/vendor partners to deliver scalable workflows and affordability initiatives.

With 10+ years in healthcare operations and 7+ years in PBM or pharmacy contexts, you will own high-impact programs, develop business cases, and drive value realization