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

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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.