PBM Technical Operations Director (REMOTE)

Lensa; Baltimore (MD); Remote; USD 140,000 - 260,000; Full time

Job summary

A leading career site is seeking a PBM Technical Operations Director for CareFirst BlueCross BlueShield. This remote role involves providing strategic leadership and oversight for technical and operational support functions in Pharmacy Benefit Management, ensuring alignment with business objectives. The ideal candidate has extensive experience in IT and management, with strong communication and problem-solving skills.

Benefits

Comprehensive benefits

Incentives

401k plans

Qualifications

• Minimum 8 years in IT or PBM operational environments.
• At least 3 years in management roles.
• Must be eligible to work in the US without sponsorship.

Responsibilities

• Lead daily technical resources supporting PBM operations.
• Manage performance evaluations and staffing decisions.
• Oversee business analyst and project management functions.

Skills

Communication

Problem-solving

Work organization

Customer service

Education

Bachelor's Degree in Business Administration, IT, or related field

Tools

Microsoft Office

Job description

PBM Technical Operations Director (REMOTE)

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Purpose

The Director, PBM Technical Operations provides leadership, oversight, and guidance to technical and operational support functions. This role involves analyzing performance and making recommendations for improvements. The Director manages the day-to-day technical support of systems supporting Pharmacy Benefit Management (PBM) programs, including technical design, implementations, deployments, and ongoing support. They provide strategic leadership for all benefit, eligibility, and transaction interfaces with third-party PBMs, ensuring support aligns with business objectives.

Essential Functions

• Lead daily technical resources supporting PBM operations, including analysis, development, and resolution of enterprise-wide issues related to benefits, eligibility, and accumulators.
• Manage performance evaluations, pay reviews, and staffing decisions. Coach and mentor staff for performance improvement, career growth, and succession planning.
• Oversee business analyst and project management functions supporting SDLC, including requirements definition, system specifications, testing, and user procedures.
• Collaborate with IT to align technical and business strategies; direct interface and collaboration between business and IT teams for project planning and change management.
• Contribute to strategic planning, monitor key metrics, manage resources and budgets, and oversee operational procedures.
• Research industry best practices in PBM operations, transaction adjudication, and data management; advise leadership on strategic initiatives.

Qualifications

Education: Bachelor's Degree in Business Administration, IT, or related field, or equivalent relevant work experience.

Experience: Minimum 8 years in IT or PBM operational environments; at least 3 years in management roles.

Skills: Excellent communication skills, problem-solving abilities, work organization, proficiency in Microsoft Office, and customer service excellence. Must be eligible to work in the US without sponsorship.

Additional Information

Salary Range: $140,000 - $259,875 (disclosed range varies by location and experience). CareFirst offers comprehensive benefits, incentives, and 401k plans.

Physical demands include primarily seated work, occasional walking and lifting up to 25 pounds.

This role is based in Maryland, US, with no sponsorship required.