Pharmacy Benefits Manager Consultant

System One; Baltimore (MD); Remote; USD 250,000 - 280,000; Full time

Job summary

A leading health insurance organization seeks a Pharmacy Benefits Manager Consultant for a contract-to-hire engagement. This role involves deep expertise in pharmacy supply chain financial management, managing vendor contracts, and leading PBM transitions. You will ensure business readiness and oversee training and documentation efforts in a collaborative environment.

Qualifications

• Minimum 7+ years in pharmacy supply chain, PBM operations, or related fields.
• Experience leading PBM transitions or implementations for a health plan.
• In lieu of a degree, 4 years of relevant experience required.

Responsibilities

• Lead and manage the business execution team to meet project goals.
• Negotiate and manage PBM and pharmacy supply chain contracts.
• Identify operational risks and implement mitigation strategies.

Skills

PBM contracting

Claims adjudication

Pharmacy networks

Rebate/discount financial flows

Compliance frameworks

Strategic decision-making

Pharmacy benefit operations knowledge

Communication skills

Leadership

Project management

Education

Bachelor’s degree in Business Administration, Healthcare Management, Supply Chain, or related field

MBA or Master’s in a business-related discipline

Job description

Job Title: Pharmacy Benefits Manager Consultant
Client: Health Insurance Organization
Location:Remote
Contract Type: Contract-to-Hire
Rate: $120/HR

Job Summary
ALTA IT Services is seeking an experienced Pharmacy Benefits Manager Consultant for a contract-to-hire engagement with a leading health insurance company. This role requires deep expertise in pharmacy supply chain financial management, PBM transitions, and pharmacy operations. The Program Manager will lead a major pharmacy supply chain implementation and PBM transition, overseeing execution activities, stakeholder alignment, contract and vendor management, and driving overall business readiness.Key Responsibilities
Project Leadership & Accountability

• Lead and manage the business execution team to meet project goals, objectives, and deadlines.
• Provide strategic direction in collaboration with business sponsors, IT, PMO, and vendors.
• Make critical business decisions in partnership with leadership stakeholders.

Contracts & Vendor Management

• Negotiate and manage PBM and pharmacy supply chain contracts, including Statements of Work (SOWs).
• Monitor vendor performance, resolving issues with IT, PMO, and Operations teams to ensure successful delivery.

Value Story Development and Communication

• Develop and validate the financial and operational value story of the PBM supply chain model.
• Collaborate with executive sponsors to align on organizational impact and cost-benefit outcomes.
• Provide regular updates to stakeholders and adjust value realization strategies as needed.

Cross-Functional Collaboration & Business Readiness

• Facilitate collaboration between IT, PMO, vendors, and business units to ensure a seamless transition.
• Translate business needs into actionable requirements and ensure clear communication across teams.
• Lead meetings with stakeholders to address project status, risks, and mitigation plans.
• Support business readiness by overseeing training, documentation, and operational transition plans.

Risk Management & Performance Optimization

• Identify operational risks and implement mitigation strategies.
• Recommend process improvements for cost efficiency and service enhancement.
• Ensure business continuity and performance throughout project lifecycle.

Qualifications
Required Education & Experience:

• Bachelor’s degree in Business Administration, Healthcare Management, Supply Chain, or related field.
• Minimum 7+ years in pharmacy supply chain, PBM operations, PBM contracting, or related fields.
• Experience leading PBM transitions or implementations for a health plan, PBM, or consulting firm.

In lieu of degree: An additional 4 years of relevant experience is required.
Preferred:

• MBA or Master’s in a business-related discipline.

Required Skills

• Deep expertise in PBM contracting, claims adjudication, pharmacy networks, and rebate/discount financial flows.
• Knowledge of compliance frameworks and regulations impacting pharmacy operations.
• Strong strategic decision-making capabilities in complex, high-visibility environments.
• Familiarity with Medicare, Medicaid, and Commercial pharmacy benefit operations.
• Excellent verbal and written communication skills across all organizational levels.
• Strong leadership and stakeholder engagement skills, including vendor and executive management.
• Proven ability to manage large-scale, multi-functional projects in fast-paced settings.

Ref: #855-IT Baltimore
#M2