Pharmacy Programs Manager

hcsc; National (WA); Remote; USD 93,000 - 168,000; Full time

Benefits offered by this job

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

Job summary

Health Care Service Corporation (HCSC) seeks a qualified professional to oversee pharmacy networks and manage day-to-day operations with external PBMs across Medicare plans. The role drives vendor performance and maintains pricing accuracy while upholding stringent regulatory standards.

This remote position is based in Nashville and requires working in the East Coast Time Zone, with opportunities for growth and a comprehensive benefits package.

Qualifications

• Experience with pharmacy networks and/or health plans.
• Project management experience.
• Verbal and written communication skills.
• Flexible and able to perform under pressure.
• PC proficiency including Word, Excel, and database experience.

Responsibilities

• Oversee pharmacy networks and manage day-to-day operations with external PBMs.
• Monitor pricing setup accuracy and maintain quality standards.
• Drive PBM vendor performance and perform claims testing.
• Ensure compliance with Medicare, Medicaid, and enterprise regulations.

Skills

Pharmacy networks experience

Project management

Verbal and written communication

Flexible under pressure

PC proficiency

Tools

Word

Excel

Database experience

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

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.

• 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.

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.

Base Pay Range

$92,700.00 - $167,500.00

Exact compensation may vary based on skills, experience, and location.