PBM Technical Operations Director (REMOTE)

CareFirst BlueCross BlueShield; Baltimore (MD); Remote; USD 140,000 - 260,000; Full time

Job summary

An established industry player is seeking a dynamic PBM Technical Operations Director to lead and enhance technical support for Pharmacy Benefit Management programs. This senior-level role involves overseeing technical resources, managing performance evaluations, and collaborating with IT to ensure strategic alignment. The successful candidate will leverage their extensive experience in IT and PBM operations to drive improvements, support corporate objectives, and mentor staff for growth. Join a forward-thinking company that values innovation and excellence in healthcare services.

Benefits

Comprehensive benefits packages

Incentive programs

401k plans

Qualifications

• 8+ years in IT or PBM operational environment.
• 3+ years management experience.

Responsibilities

• Lead technical resources for PBM operations and manage performance evaluations.
• Collaborate with IT to align business and technology strategies.

Skills

Leadership

Problem-solving

Communication

Microsoft Office

Education

Bachelor's Degree in Business Administration

Bachelor's Degree in IT

Job description

PBM Technical Operations Director (REMOTE)

Join to apply for the PBM Technical Operations Director (REMOTE) role at CareFirst BlueCross BlueShield

Job Overview

The Director, PBM Technical Operations provides leadership, oversight, and guidance to technical and operational support functions. They analyze performance and recommend improvements, directing the day-to-day technical support of systems supporting all Pharmacy Benefit Management (PBM) programs, technical design, implementations, deployments, and ongoing support. The role involves providing corporate leadership, vision, and direction for the technical enablement of key business functions, including benefit, eligibility, and transaction interfaces with third-party PBMs. The director ensures support of the company's business objectives and strategic corporate functions.

Responsibilities & Qualifications

• Lead technical resources for PBM operations, supporting benefits, eligibility, and accumulators. Includes analysis, development, resolution of enterprise-wide problems, system monitoring, and external representation.
• Manage performance evaluations, pay reviews, hiring, and termination decisions. Coach and mentor staff for performance improvement, career growth, and succession planning.
• Oversee business analysts and project management supporting SDLC functions, including requirements definition, system specifications, testing, and user procedures.
• Collaborate with IT to align business and technology strategies; oversee interface and collaboration efforts for project implementation and change management.
• Develop and monitor strategic and tactical plans, key metrics, resource and budget plans, and support procedures.
• Maintain industry knowledge of PBM operations, transaction adjudication, and data management to advise on strategies and operational best practices.

Qualifications

• Bachelor's Degree in Business Administration, IT, or related field, or equivalent work experience.
• 8+ years in IT or PBM operational environment.
• 3+ years management experience.
• Strong communication skills, problem-solving ability, and proficiency in Microsoft Office.

Additional Details

Salary Range: $140,000 - $259,875 (disclosed range varies by location and experience). Benefits include comprehensive packages, incentive programs, and 401k plans.

Must be eligible to work in the U.S. without sponsorship. The role is full-time, senior-level management, within the industries of IT services, financial services, and healthcare.