Pharmacy Programs Manager

Health Care Service Corp.; National (WA); Hybrid; USD 93,000 - 168,000; Full time

Job summary

Health Care Service Corporation is seeking a Senior Pharmacy Network Manager to oversee the pharmacy network and collaborate with PBMs for Medicare plans. You will drive performance, monitor pricing accuracy, and ensure operational standards are met while maintaining strict regulatory compliance.

The role requires experience with pharmacy networks and project management, strong communication skills, and proficiency in Word/Excel.

Qualifications

• Experience with pharmacy networks and/or health plans.
• Strong verbal and written communication skills.
• Project management experience and ability to perform under pressure.
• PC proficiency including Word and Excel; database experience.

Responsibilities

• Provide comprehensive pharmacy network oversight across Medicare plans.
• Manage day-to-day operations with external PBMs.
• Monitor network pharmacies for pricing accuracy and quality standards.
• Ensure compliance with Medicare, Medicaid, and enterprise regulatory standards.

Skills

Project management

Communication skills

Word & Excel proficiency

Database experience

Tools

Microsoft Word

Microsoft Excel

Database systems

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

Provides comprehensive pharmacy network oversight and manages day-to-day operations with external pharmacy benefit managers across all Medicare plans. Continuously monitors network pharmacies to ensure pricing setup accuracy and maintain strict operational quality standards. Drives PBM vendor performance and operational integrity through claims research, rigorous testing of benefit design implementations, and direct oversight of PBM mail order and customer service functions. Ensures strict compliance with all Medicare, Medicaid, and enterprise regulatory standards.

Job Requirements:

Previous experience with pharmacy networks and/or health plans Project management experience. Verbal and written communication skills. Flexible and ability to perform under pressure. PC proficiency including Word and Excel and database experience. This role is Remote in Nashville and requires working in East Coast Time Zone #LI-Remote #LI-AC1

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii. Base Pay Range $92,700.00 - $167,500.00 Exact compensation may vary based on skills, experience, and location.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned.