Team Leader - Pharmacy Business Support (PBM Oversight)

Wellmark, Inc.; Des Moines (IA); Hybrid; USD 90,000 - 135,000; Full time

Job summary

Wellmark, Inc. is seeking a Team Leader for Pharmacy Business Support (PBM Oversight) in Des Moines, IA.

You will lead a growing team overseeing PBM and other pharmacy vendors, partnering across departments to strengthen oversight and vendor partnerships. The role requires strong leadership, strategic thinking, and ability to influence across the organization, with a hybrid schedule of in-office and remote work and a focus on cost of care.

Qualifications

• Bachelor’s degree in business, health care administration, or a related field is required.
• 4+ years of experience in health insurance, Operations, PBM, or pharmacy benefit administration.
• Demonstrated leadership experience with cross-functional or matrixed teams.
• Strong written and verbal communication skills with the ability to communicate with vendor partners.
• Understanding of applicable rules, regulations, and guidelines affecting the department.

Responsibilities

• Provide leadership and day-to-day management of financial and human resources, including coaching and budgeting for staff.
• Support business objectives with timely, accurate results and monitor key metrics for improvement.
• Serve as primary liaison with CVS for non-clinical aspects of the pharmacy benefit and ensure proper implementation of business requirements.
• Oversee quality assurance, compliance monitoring, and performance tracking related to PBM services.
• Cascade operational strategy to the team and drive service excellence across stakeholders.
• Collaborate with the Pharmacy Product team to inform strategy and roadmap, providing subject matter expertise.
• Ensure adherence to contractual, regulatory, and accreditation standards (CMS, NCQA) through oversight and documentation.
• Promote a culture of accountability and innovation; lead change management across the team.

Skills

Leadership

Vendor oversight

Communication

Cross-functional collaboration

Data-driven decisions

Education

Bachelor’s degree in business, health care administration, or related field

Tools

PBM systems

Job description

Team Leader - Pharmacy Business Support (PBM Oversight)

• Full-time
• Department: Clinical | Health Networks | Provider Support
• Pay Grade: 24

Use your strengths at Wellmark as a Team Leader of PharmacyBusiness Support!

AsaTeam Leader of Pharmacy Business Support, you will lead and develop a growingPharmacy Performanceteamdedicated to ensuring rigorous oversight ofWellmark’s Pharmacy Benefits Manager (PBM) and other pharmacy vendors.

With yourstrong communicationskillsand ability to effectively buildprofessionalpartnershipsacross an organization and externally, you are energized by the idea ofenhancing ourvendoroversight to a state of maturity.Youthink criticallytoidentifyprocessgaps, risks,efficienciesand trends.You have a unique ability to influence others in a collaborative manner.

As a leader of others, you will directlyimpactthe success, growth, and development of team members by setting clear expectations, defining accountabilities, providing regular coaching,facilitatingchange, and providing an overall positive work environment. Being a role model in behaviors thatdemonstrate Wellmark’s Leader Success Expectations isa must. You are a strong change leader whodemonstratesboth flexibility and resiliency. You are at your best when you can strategically think both up and downstream, use data to inform decisions, and creatively solve problems – plus, you love to inspire and coach others to do the same.

The workwon’tbe easy, but you are excited about the opportunity to join a growing, highly visible area ofthe businessfocused on the total cost of health care.

This position willwork a hybrid schedule of at least 3 days in Wellmark's Des Moines office, with 2 days remote option.As a leader, theremay beadditionaldays in the office to meet business needs.

Preferred Qualifications - Great to have:

• MBA or advanced degree in a related field.
• Experience working with vendor’s such as CVS or other PBMs in a health plan setting.
• Familiarity with Medicare Part D, compliance frameworks, and pharmacy data systems.

Required Qualifications - Must have:

• Bachelor’s degree in business, health care administration, or related field, or equivalent experience.
• 4+ years of experience in health insurance, Operations, PBM, or pharmacy benefit administration.
• Demonstrated leadership experience with cross-functional or matrixed teams. Ability to operate with agility and flexibility; effectively moves from strategy to tactics to operations.
• Leadership experience gained through a combination of project or informal leadership.
• Strong understanding of pharmacy benefit design, claims processing, and vendor oversight.
• Ability to measure, evaluate and/or improve work processes, programs, and services; ensures alignment with strategic goals.
• Strong written and verbal communication skills with the ability to effectively communicate information to varying audiences, including vendor partners.
• Understanding of applicable rules, regulations, and guidelines. Must be aware of implications to department.
• Strong consulting and critical thinking skills with the ability to provide insights and recommendations, influence others to action, and produce customer-focused solutions.
• Effective time management and organizational skills with the ability to prioritize initiatives, align appropriate resources, clearly articulate expectations to others, and motivate teams in order to achieve success.
• Adaptable and flexible with change and also have the ability to effectively lead teams through change.

What you will do as a Team Leader - Pharmacy Business Support:

a. Provide leadership and day-to-day management of financial and human resources, primarily focusing on employee coaching, development, performance improvement, coordination and budgeting for staff and department(s) specific functions/services.
b. Support business objectives and produce results that are effective, accurate, timely, and on target to meet business and stakeholder needs. Identify, monitor and communicate critical business metrics to ensure project execution success and leverage results for future process improvements.
c. Serve as a primary liaison with CVS for non-clinical aspects of the pharmacy benefit, ensuring accurate implementation of Wellmark’s business requirements.
d. Oversee quality assurance, compliance monitoring, and performance tracking related to PBM services and internal pharmacy support functions.
e. Cascade and communicate operational strategy and initiatives to team members, driving customer/ stakeholder service, supporting achievement of overall company results.
f. Collaborate with the Pharmacy Product team to inform product strategy, contribute to roadmap planning, and provide subject matter expertise.
g. Ensure adherence to contractual, regulatory, and accreditation standards (e.g., CMS, HEDIS, NCQA) through effective oversight and documentation.
h. Support enterprise initiatives by representing non-clinical pharmacy perspectives in cross-functional workgroups and strategic planning efforts.
i. Promote a culture of accountability, innovation, and service excellence across the team.
j. Partner with internal stakeholders (e.g., Compliance, Legal, Product, and Technology) to ensure timely resolution of issues and alignment with enterprise priorities.
k. Monitor and analyze performance metrics to identify trends, risks, and opportunities for improvement.
l. Contribute to the development and maintenance of policies, procedures, and training materials to support consistent and compliant execution of responsibilities.
m. Other duties as assigned.

This job requires a non-compete agreement.

An Equal Opportunity Employer

The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.

Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at [e-mail]

At this time, Wellmark is not considering applicants for this position that require any type of immigration sponsorship (additional work authorization or permanent work authorization) now or in the future to work in the United States. This includes, but IS NOT LIMITED TO: F1-OPT, F1-CPT, H-1B, TN, L-1, J-1, etc. For additional information around work authorization needs please refer to the following resources: Nonimmigrant Workers and Green Card for Employment-Based Immigrants

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