Senior Director, Pharmacy and PBM Operations

* 12+ years of extensive experience in PBM operations, including interaction with self-funded and employer-sponsored health plan benefits.* Doctor of Pharmacy preferred.* Knowledge of accreditation standards (URAC, ACHC) is a plus.* Comprehensive knowledge of PBM/pharmacy/healthcare industry, PBM operations, third party administrators, benefit setup (ASO and fully-insured), pharmacy claims, and managed care.* Strong understanding of PBM processes: claims adjudication, network development, pricing, analytics/reporting, rebates, clinical aspects, trade, contracting, systems, and account management.* Experience negotiating contracts with PBMs and pharmacies.* Visionary mindset with the ability to anticipate and navigate emerging changes in the healthcare landscape and identify innovative solutions to complex challenges.* Exceptional communication skills to convey complex PBM/pharmacy concepts to diverse stakeholders, fostering clear understanding and driving organizational success.* Proven change agent with the ability to initiate and lead initiatives, motivate teams, and foster a culture of adaptability, high performance, accountability, excellence, and continuous improvement.* High proficiency in project management methodologies for effective planning, execution, and monitoring of key initiatives, ensuring timely delivery of results.* Strong analytical and problem-solving skills with attention to detail for addressing complex operational challenges.* Ability to manage expectations and facilitate understanding at all organizational levels, both internally and externally.* Capacity to lead, oversee, prioritize, and handle multiple projects and clients with dynamic and shifting timelines, utilizing proven project management processes.* Demonstrated success in driving operational excellence and executing process improvements in a high-growth, fast-paced, entrepreneurial business setting, with a focus on measuring results and achieving targeted outcomes.Our benefits solution empowers patients with concierge support, coaching, education, and digital tools;provides access to a premier network of fertility and women's health specialists who use the latest science and technologies; drives optimal clinical outcomes; and reduces healthcare costs.Our mission is toempower healthier, supported journeys through transformative fertility, family building and women’s health benefits.- Family friendly benefits: Paid family and parental leave, preconception, fertility and family building benefits (including egg freezing, IVF, and adoption support), family and pet care fund, and Parents’ Employee Affiliation Group There are a variety of factors that go into determining a salary range, including but not limited to external market benchmark data, geographic location, and years of experience sought/required. Progyny offers a total compensation package comprised of base salary, cash bonus, and equity.Progyny is proud to be anEqual Opportunity and Affirmative Action employer.We respect and seek to empower each individual and support the diverse cultures, perspectives,skillsand experiences within our workforce. All qualified applicants will receive consideration for employment without regard to race, creed, color, religion, sex, sexual orientation, gender identity or expression, national origin, disability, age, genetic information, marital status, pregnancy or related condition, status as a protected veteran, criminal history consistent with legal requirements or any other basis protected by law.Our Growth is Creating Great Opportunities!Progyny is growing and we want to hire the most talented people we can. Continued success depends on it! Once you've had a chance to explore our current open positions, apply to the ones you feel suit you best and keep track of both your progress in the selection process, and new postings that might interest you!Progyny is proud to be an Equal Opportunity and Affirmative Action employer.We respect and seek to empower each individual and support the diverse cultures, perspectives,skillsand experiences within our workforce. All qualified applicants will receive consideration for employment without regard to race, creed, color, religion, sex, sexual orientation, gender identity or expression, national origin, disability, age, genetic information, marital status, pregnancy or related condition, status as a protected veteran, criminal history consistent with legal requirements or any other basis protected by law.If you are an individual with a disability and need assistance or an accommodation during the recruiting process, please send an e-mail to you for your interest in Progyny!
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