SummaryThis role provides senior leadership over pharmacy PBM quality and testing for large scale Medicaid implementations. The position owns end to end testing strategy and execution, ensuring reliable, compliant, and high quality pharmacy solutions. The role partners closely with business, product, state, and delivery teams while managing budgets, vendors, and testing teams to deliver successful client outcomes and continuous service improvement.
Your role in our mission- Manages functional areas or department account leads on large accounts to ensure that business solution objectives are met. Identifies and manages the implementation of process improvements.
- Manages and develops demand forecasts with account teams on large accounts to assist functional areas or departments in planning and delivering end-to-end services. Identifies issues and recommends alternative approaches.
- Works with functional areas or departments to interpret and plan projects or workload forecasts. Provides advice and counsel regarding various results.
- Prepares, recommends and oversees development of operating and personnel budgets. Monitors spending for adherence to budget plans, develops and recommends variances. Performs and/or oversees budget analysis.
- Manages and approves expenditures for accounts in line with established policies and procedures.
- Manages complex relationships between delivery and consumer groups to ensure good client relations. Resolves issues and determines and implements appropriate course of action.
- Identifies and manages service improvements to increase customer satisfaction. Manages and ensures delivery of projects meet client and company expectations and needs.
- Partners with functional areas or departments to integrate new, enhanced and existing service offerings for accounts.
- Participates in developing new business proposals and introduces new technology to enhance business solutions.
- Selects and hires employees. Trains and evaluates employees to enhance their performance, development, and work product. Addresses performance issues and makes recommendations for personnel actions. Motivates and rewards employees including providing salary increases, bonuses and promotions within allocated budgets and company guidelines.
What we're looking for- 13 or more years of Leading end to end pharmacy testing strategy and execution across SIT, UAT, Parallel, regression and automation for large scale Medicaid PBM implementations.
- Own quality outcomes for pharmacy solutions, including claims (NCPDP D.0/F6), PDLs, DUR, rebates, encounters, and financial cycles.
- Provide senior level oversight of multi vendor, onshore/offshore testing teams, driving clear accountability, defect ownership, and delivery excellence.
- Partner closely with Product, Business, State to validate requirements, ensure regulatory compliance, and support production ready outcomes.
- Establish and report testing KPIs, quality metrics, and executive dashboards; proactively identify risks, dependencies, and mitigation plans.
What you should expect in this role- Remote position from US locations.
- Opportunities to travel through your work (0-20%).
- Willingness to work a flexible schedule to accommodate business needs and travel as required.
- Video cameras must be used during all interviews, as well as during the initial week of orientation
The deadline to submit applications for this posting is
July 31, 2026.The pay range for this position is $101,300.00 - $144,700.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
