Team Leader - Pharmacy Business Support (PBM Oversight)

Wellmark, Inc.; Iowa; Hybrid; USD 120,000 - 150,000; Full time

Job summary

Wellmark, Inc. is seeking a Team Leader of Pharmacy Business Support in a hybrid role based in Des Moines, IA. You will lead the Pharmacy Performance team overseeing PBM and pharmacy vendors, influence change, and drive cost-effective, compliant outcomes.

You will manage staff, coach for growth, collaborate across functions, and ensure alignment with CMS/NCQA standards while advancing vendor oversight maturity.

Qualifications

• 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 with cross-functional or matrixed teams and agility.
• Strong understanding of pharmacy benefit design, claims processing, and vendor oversight.
• Strong written and verbal communication, with ability to influence and present to varied audiences.

Responsibilities

• Provide leadership and day-to-day management of finance and human resources for the team, including coaching and budgeting.
• Support business objectives, monitor metrics, and drive results aligned to strategic goals.
• Serve as primary liaison with CVS for non-clinical PBM aspects and ensure requirements are implemented.
• Oversee QA, compliance monitoring, and performance tracking of PBM services.
• Cascade strategy to team members and drive customer/stakeholder service excellence.
• Collaborate with Pharmacy Product team to inform roadmap and provide SME input.
• Ensure adherence to contractual, regulatory, and accreditation standards (CMS, NCQA).
• Represent non-clinical pharmacy perspectives in cross-functional workgroups and enterprise initiatives.
• Promote accountability, innovation, and a positive work environment; lead change effectively.
• Partner with Compliance, Legal, Product, and Technology to resolve issues and align priorities.
• Monitor performance metrics to identify trends, risks, and improvement opportunities.

Skills

Leadership

Vendor oversight

Pharmacy benefits knowledge

Strategic thinking

Data-driven decision making

Cross-functional collaboration

Education

Bachelor’s degree in business or health care administration

Tools

PBM systems

Regulatory/compliance systems

Job description

Why Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation,

Learn more about our unique benefit offerings here.

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 directlyimpact the 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 thatdemonstrateWellmark’s Leader Success Expectationsisa 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 willworka hybrid schedule of at least 3 days in Wellmark's Des Moines office, with 2 days remoteoption.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.
• -Formal people-leadership experience.

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.
• -Proficiencyin HRORpreferred.

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]

Please inform us if you meet the definition of a Covered DoD official.

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

Wellmark supports and expects the responsible use of AI for our workforce! We welcome the responsible use of these tools by job seekers as well and are interested in learning from you; you will have an opportunity in the application process to share which tools you used and how you applied them.