Location:
Remote (Candidates must reside in the Northeast U.S. and be open to the occasional onsite visit as needed)
Schedule:
Full-time | Monday – Friday, 9:00 AM – 5:00 PM EST
Position Overview
We are seeking an accomplished, visionary executive to serve as President of Pharmacy Services. In this enterprise leadership role, you will hold direct P&L accountability and set the strategic, commercial, and operational vision for our pharmacy business.
You will direct overall business growth, modernize core systems, expand commercial market share, and lead high-volume pharmacy operations—including claims adjudication, formulary management, specialty services, and vendor partnerships. The ideal candidate pairs deep health plan or PBM operational expertise with an executive track record of driving revenue growth, scaling client relationships, and leading organizational transformation across complex healthcare environments.
Note: This position is 100% remote; however, candidates must be permanently based within the Northeast region.
Key ResponsibilitiesStrategic & Operational Leadership
- Establish and execute the long-term business strategy, multi-year operating plans, and enterprise growth targets.
- Direct end-to-end pharmacy benefit operations, service delivery, customer experience, and overall organizational performance.
- Identify operational leverage, streamline workflows, improve operational scalability, and sharpen market competitiveness.
- Champion continuous process improvement while ensuring service continuity, operational stability, and SLA adherence.
Commercial Growth & Business Development
- Formulate commercial strategies to drive new client acquisition, expand organic account footprint, and protect client retention.
- Provide strategic direction across sales operations, go-to-market strategies, consultant relationships, and brand positioning.
- Direct high-stakes RFP responses, pricing and underwriting models, contract negotiations, and strategic commercial partnerships.
- Spearhead the design, packaging, and commercialization of new pharmacy products, clinical solutions, and tech-enabled capabilities.
Financial & Business Performance
- Hold full executive accountability for the business unit's P&L, top-line revenue, operating margins, and bottom-line outcomes.
- Direct financial planning, multi-year forecasting, operational budgeting, and risk-adjusted pricing frameworks.
- Continually analyze business economics, unit costs, drug spend trends, and capital allocation to fuel sustainable profitability.
- Define and institutionalize enterprise-wide KPIs, financial targets, and operational scorecards.
Pharmacy & Clinical Operations
- Provide executive oversight across pharmacy benefit administration, claims adjudication, formulary strategy, utilization management (UM), and specialty pharmacy programs.
- Govern strategic relationships with pharmacy retail networks, wholesalers, manufacturers, and outsourced service partners.
- Champion clinical models centered on drug access, affordability, quality metrics, and improved patient health outcomes.
- Ensure pharmacy programs remain agile, compliant with regulatory mandates, and responsive to evolving client and market demands.
Technology & Business Transformation
- Champion major technology modernizations across core operating platforms, adjudication engines, and digital service channels.
- Prioritize capital investments in data analytics, automation, workflow digitization, and operational tooling.
- Drive cross-functional transformation programs that enhance reporting transparency, member experience, and inter-departmental velocity.
- Steer organizational change management, minimizing business disruption during operational migrations and system integrations.
Executive & Organizational Leadership
- Build, mentor, and inspire a world-class executive and senior operational leadership team across clinical, operational, and commercial disciplines.
- Establish organizational values, strategic priorities, and an accountable, high-performance culture.
- Partner with enterprise executive peers across Finance, Clinical, Product, Legal, Compliance, IT, and Commercial functions.
- Drive talent assessment, succession planning, and executive leadership development across the remote workforce.
Qualifications & RequirementsRequired Experience
- Work Authorization & Location: Must currently reside within the Northeast United States (e.g., NY, NJ, PA, CT, MA, RI, VT, NH, ME).
- Industry Experience: 15+ years of progressive leadership experience within a PBM, pharmacy services organization, managed care organization (MCO), or health plan.
- Senior Leadership: Demonstrated tenure in a senior executive role overseeing complex, multi-faceted pharmacy business operations.
- P&L Accountability: Proven track record owning, managing, and optimizing a significant business P&L, budget, and financial growth model.
- PBM Subject Matter Expertise: Comprehensive understanding of pharmacy benefit administration, adjudication systems, formulary economics, and industry financial structures.
- Growth & Transformation: Demonstrated success scaling business lines, delivering commercial growth, improving operational efficiency, and leading enterprise change.
- People Leadership: Proven ability to manage, develop, and align cross-functional executive teams in a matrixed or distributed environment.
Preferred Experience
- Prior service as a President, General Manager (GM), Chief Operating Officer (COO), or senior business-unit head within healthcare services.
- Experience commercializing new pharmacy products, digital health offerings, or employer/payer solutions.
- Sophisticated knowledge of specialty pharmacy management, drug pipeline economics, rebate/formulary dynamics, and pharmaceutical manufacturer relations.
- Experience leading enterprise platform migrations, technology modernization initiatives, or M&A integration programs.
- In-depth exposure to self-funded employer (ASO), Commercial, Medicare Part D, and Medicaid lines of business.
- Demonstrated mastery of evolving healthcare regulations, pricing transparency laws, and state/federal PBM compliance requirements.
- Work Arrangement: 100% Remote (residence in the Northeast U.S. required)
- Schedule: Full-time | Monday through Friday, 9:00 AM – 5:00 PM EST (with executive flexibility as business demands dictate)