Director of Plan Operations - Pharmacy Benefits

North Carolina; Raleigh (NC); On-site; USD 100,000 - 130,000; Full time

Job summary

The State of North Carolina is seeking a Director of Plan Operations for its Pharmacy Benefits sector. This full-time role involves overseeing pharmacy benefit management and programs, ensuring compliance and operational efficiency while providing healthcare coverage to a vast demographic of teachers, state employees, and their dependents. Candidates should possess substantial experience in pharmacy services, operational processes, and benefit management, supported by a relevant Bachelor's degree.

Benefits

Health insurance

Paid vacation

Sick leave

Holidays

Retirement benefits

Qualifications

• At least 7 years of progressive experience in pharmacy services.
• Minimum of 3 years in pharmacy benefit manager contract management and compliance.

Responsibilities

• Oversee pharmacy RFPs and contracts.
• Manage pharmacy benefit programs implementation.
• Develop operational processes for retiree drug subsidy.

Skills

Auditing

Policy Development

Program Implementation

Education

Bachelor’s degree in a relevant field

Job description

Director of Plan Operations - Pharmacy Benefits

Join to apply for the Director of Plan Operations - Pharmacy Benefits role at State of North Carolina.

This is a reposting; current applicants do not need to re-apply.

The NC State Health Plan is hiring a Director of Plan Operations to oversee the Pharmacy Benefits Manager (PBM) Contract, pharmacy operations, the Employer Group Waiver Plans (EGWP) program, and EGWP enrollment. This full-time position (40 hours/week) offers State Benefits, including health insurance, paid vacation, sick leave, holidays, and retirement.

This position is classified as Exempt per North Carolina General Statute 126-5 (c1)(c23)(24).

About The State Health Plan

The North Carolina State Health Plan for Teachers and State Employees provides healthcare coverage to over 740,000 teachers, school personnel, state employees, retirees, lawmakers, university and community college faculty and staff, and their dependents.

Responsibilities

• Development and oversight of pharmacy RFPs and contracts.
• Implementation and management of pharmacy benefit programs.
• Develop and manage operational processes to maximize receipt of retiree drug subsidy (RDS) and other Part D programs such as EGWP.
• Collaborate with SHP leadership to develop programs and benefit designs aligned with the Board of Trustee’s strategic plan.

In line with the Department of State Treasurer's ethics policies, this position is subject to ethics and conflict of interest requirements outlined in the Supplemental Ethics Policy (Tier 2).

Qualifications

• Experience auditing pharmacy benefit managers for processing accuracy.
• Experience developing and implementing policies and programs to meet Plan goals, including cost-effective benefit design.
• Experience managing operational processes for RDS and Part D programs.

Minimum Education and Experience

Bachelor’s degree in a relevant field with at least 7 years of progressive experience in pharmacy services within a healthcare environment, including a minimum of 3 years in pharmacy benefit manager contract management and compliance.

Application Process

Please submit your application online via the specified website. The position requires passing a criminal background check and may include review of employment history, references, credit, and educational verification. All applicants must complete a full state application; resumes alone are not sufficient for screening.

Additional Information

The State of North Carolina is an Equal Opportunity Employer. Accommodations under the ADA, veteran's preference, and National Guard preferences are available upon request. Foreign degrees must be evaluated for U.S. equivalency. For application support or questions, contact [e-mail] or the NeoGov Help Line.