Senior Manager, Pharmacy Benefits Job at Healthfirst

Senior Manager, Client Benefits

Design, plan, and manage information technology (IT) projects to deliver efficie...

Location

United States , Woonsocket

Salary:

125590.00 - 162700.00 USD / Year

CVS Health

Expiration Date

Until further notice

Requirements

Bachelor’s degree (or foreign equivalent) in Computer Science, Computer Engineering, Information Technology, Engineering, or a related field
5 years of progressive, postbaccalaureate experience in the job offered or related occupation
5 years of experience in Software development lifecycle (SDLC)
5 years of experience in Software development best practices
5 years of experience in Agile methodologies or SAFe Software Development Principles
5 years of experience in XML, JSON, HTML, CSS, or JavaScript
5 years of experience in SAS or SQL
5 years of experience in Natural Language Processing (NLP): Scikit-Learn, SpaCity, Pytorch, or Spark NLP
5 years of experience in IBM Mainframes: COBOL, JCL, CICS, VSAM, or DB2
5 years of experience in Relational database concepts

Job Responsibility

Design, plan, and manage information technology (IT) projects to deliver efficient technical solutions
Manage project execution for multiple software applications to ensure adherence to quality assurance standards, schedule, and scope
Serve as client point of contact in defining technology driven solutions to meet business objectives
Define project plans, strategy, and roadmap and measure progress against timelines and deliverables
Oversee and approve solutions design and develop structures and accurate benefit plan requirements to achieve intended outcomes or recommend alternatives
Serve as the subject matter expert and work with key stakeholders to determine project requirements and objectives and translate into high quality products that promote customer satisfaction
Confer with project personnel to identity and resolve problem and ensure alignment between internal teams and clients on decision making and objectives
Leverage operational metrics and production error root cause information to improve requirements gathering, configuration, and testing processes
Develop updated project plans to include new capabilities and ensure team resources are available for successful projects and initiatives
Evaluate and recommend tools, technologies, and processes to produce high quality software product platforms, and collaborate with benefits and clinical teams and customers to produce cutting-edge solutions

What we offer

CVS Health bonus, commission or short-term incentive program
Company equity award program
Full range of medical, dental, and vision benefits
401(k) retirement savings plan
Employee Stock Purchase Plan
Fully-paid term life insurance plan
Short-term and long term disability benefits
Well-being programs
Education assistance
Free development courses

Fulltime

Senior Manager, Pharmacy Benefits

The Senior Manager, Pharmacy Benefits is responsible for the overall leadership ...

Location

United States , New York

Salary:

105100.00 - 188020.00 USD / Year

Healthfirst

Expiration Date

Until further notice

Requirements

Doctor of Pharmacy (PharmD) from an accredited institution
Licensed Pharmacist in good standing
Knowledge of regulations of the Centers for Medicare and Medicaid Services and the New York State Department of Health
Knowledge of specialty pharmaceuticals and billing practices in the medical and pharmacy benefits
Experience with pharmacy benefit management oversight including maintaining policies and procedures related to formulary design and utilization management processes

Job Responsibility

Works collaboratively to design and manage the Healthfirst Pharmacy Benefit for all plans
Strategically leads the development, planning and implementation of the annual pharmacy benefit cycle to ensure that pharmacy benefits are in-line with Healthfirst Product Strategy, PBM capabilities and regulatory timeframes
Reviews and facilitates the response and/or the action plan for all applicable CMS memos and other notifications
Collaborates with Pharmacy, Actuary, Finance, Medical Economics and Product teams to analyze and present monthly cost trends for all lines of business
Partners with designated team members to develop, coordinate and manage drug related medical coverage policies
Supports pharmacy leadership efforts to drive improvement of product quality goals
Manages the Benefits team and works with others on the Pharmacy team to oversee administration and monitoring of pharmacy benefit operations along with oversight of the PBM
Performs Utilization Management reviews of relevant drugs when necessary
Assists in regulatory and compliance audits for all designated plans. Acts as pharmacy department liaison with vendors and regulatory organizations completing audits for applicable plans
Completes all required company compliance standards required

What we offer

medical, dental and vision coverage
incentive and recognition programs
life insurance
401k contributions

Fulltime

Senior Director, Ambulatory Pharmacy Services

The Senior Director, Ambulatory Pharmacy Services is responsible for the oversig...

Location

United States of America , Rochester

Salary:

192317.00 - 249995.00 USD / Year

University of Rochester

Expiration Date

Until further notice

Requirements

Bachelor’s degree in pharmacy required
Master’s degree preferred
5 years of experience in hospital pharmacy or equivalent combination of education and experience required
3 years of experience in pharmacy management required
PHARMD - Licensed Pharmacist in New York State upon hire required

Job Responsibility

Oversight, operational integrity, regulatory/legal compliance and financial performance for all Ambulatory/Outpatient pharmacy programs
Provides direction in Ambulatory/Outpatient Pharmacy to include business development, operations management, clinical services, pharmacy data analytics, and pharmacy procurement/inventory management
Develops strategy for new Ambulatory Pharmacy program development and implementation across the system
Assures highly reliable, safe pharmacy operations at all UR Medicine outpatient pharmacies
Develops and implements policies and procedures
Reviews and manages all safety concerns
Develops and implements pharmacy services that are patient- and family-centered
Identifies needs for expansion and improvement of outpatient pharmacy services
Actively participates in the strategic planning process
Oversight responsibility for recruitment and retention of staff

Fulltime

Lead Clinical Pharmacy Technician

The Clinical Pharmacy Technician supervises a team of pharmacist(s), technician(...

Location

United States , Maple Grove

Salary:

15.85 - 25.50 USD / Hour

Thrifty White

Expiration Date

Until further notice

Requirements

Graduation from a high school or GED equivalent required
Must be age 18 to work as a technician
Current state certification and/or registration as a Pharmacy Technician (CPhT preferred) or willingness to complete required training and certification
Prefer one year experience in a similar position requiring leadership and clinical services knowledge
Prior community pharmacy experience strongly preferred
Strong communication skills with ability to engage and build rapport with patients and healthcare providers
Detail-oriented with excellent organizational and documentation skills
Comfortable using pharmacy technology platforms, clinical documentation systems, and data reporting tools
Willingness to receive Community Health Worker Training
Ability to read and converse fluently in English

Job Responsibility

Team Leadership: Provides a pharmacy atmosphere and excellent customer service to develop and maintain patient and employee loyalty
Welcomes partnership of management to leverage tools, reports, and processes to exceed sales goals
Leads team to meet and exceed financial goals including payroll, sales, and clinical service expectations
Leads team by modeling, coaching, and maintaining high standards in patient service
Leverages Regional Support Pharmacy Manager, Regional Support Pharmacist, and Senior Regional Support Pharmacist for personal and team development
Organizes and directs workflow
Provides professional services to customers by presenting a positive image of the pharmacy and store while leading by example
Manages pharmacy according to state, federal and company regulations to ensure compliance
Maintains clean, neat, and well-organized pharmacy
Develops and follows up on long term care (LTC) business through immediate communication and attention to the needs of the nursing homes, group homes and assisted living residences

What we offer

401(k)
Competitive salary
Dental insurance
Flexible schedule
Health insurance
Opportunity for advancement
Paid time off
Profit sharing
Training & development
Vision insurance

Fulltime

Pharmacy Account Executive

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Work at Home

Salary:

54400.00 - 113934.00 USD / Year

CVS Health

Expiration Date

May 29, 2026

Requirements

5+ years of cumulative Account Management or equivalent client-facing experience in healthcare
Account Management experience or equivalent client-facing experience in pharmacy or PBM industry
Experience managing employer group or health plan accounts
Proficiency in Word, Excel, PowerPoint
Bachelor's degree or equivalent experience may be considered

Job Responsibility

Serve as the senior level liaison for PBM clients
Interface with Leadership both internally and externally
Grow business through renewal, retention, and up-sell of existing clients
Lead the strategic account team as the quarterback with full ownership for client satisfaction and service delivery
Develop strong internal and client relationships through proactive interactions and strong verbal and written communication skills
Work collaboratively with internal teams including medical, account management, clinical, product, operations, and underwriting
Utilize consultative selling skills to recommend CVS Health solutions to meet key client needs and Influence client up-sell opportunities
Develop and deliver quarterly and annual reporting to clients on their drug trend, financial performance, and client cost-saving opportunities
Formulate responses to Request for Proposals (RFPs) through collaboration with primary internal partners, including underwriting, networks, operations, trade and legal
Execute client renewals by building relationships with key client stakeholders and asking effective probing questions that lead to innovative pharmacy benefit plan designs

What we offer

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance

Fulltime

Market Access Private Insurance Senior Manager

Join Amgen’s Mission of Serving Patients. At Amgen, if you feel like you’re part...

Location

Canada , Ontario

Salary:

149929.00 - 199919.00 CAD / Year

Amgen

Expiration Date

Until further notice

Requirements

Bachelor's degree in life sciences, business, health economics, or a related field
Minimum of 10 years of demonstrated experience working with or for private insurers and/or payer organizations
Demonstrated experience of working with or for a pharmaceutical/biopharmaceutical manufacturer, with a focus on market access, reimbursement, or private payer strategy
Recognized expertise in the Canadian private payer landscape, including insurers and PBMs
Strong, established relationships across the private insurance ecosystem
Deep understanding of drug reimbursement processes, pricing frameworks, and formulary decision-making
Proven experience leading payer negotiations
Demonstrated ability to operate strategically and influence at a senior level
Demonstrated ability to analyze complex data and translate insights into actionable strategies
Excellent communication, negotiation, and stakeholder management skills

Job Responsibility

Lead the development and execution of the Private Insurance strategic plan across the portfolio, including innovator and biosimilar products
Define and execute tailored payer strategies for key private insurance customers to optimize formulary positioning and maximize patient access across the Amgen portfolio
Own and deliver against private payer access objectives, including coverage, patient access, and financial performance
Generate and leverage data-driven insights to identify opportunities, shape strategy, and inform business decisions
Identify access barriers and implement solutions (e.g., coverage policy optimization, prior authorization support) to enhance patient access
Lead private payer strategy for new product launches and indications, ensuring timely, competitive, and sustainable coverage
Evolve payer strategies across the product lifecycle in response to market dynamics, competitive pressures, and policy changes
Strengthen and expand strategic relationships with key private insurance stakeholders, including insurers, pharmacy benefit managers (PBMs), brokers, plan sponsors, and other payer decision-makers
Represent the organization in external forums, industry associations, and working groups, demonstrating strong executive presence and reinforcing organizational credibility
Lead complex negotiations and strategic engagements with private payers to secure and sustain optimal access outcomes

What we offer

competitive and comprehensive Total Rewards Plans that are aligned with local industry standards

Fulltime

Public & Labor Account Executive

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Scottsdale

Salary:

60400.00 - 126582.00 USD / Year

CVS Health

Expiration Date

July 07, 2026

Requirements

Proven success managing complex, high-profile clients in healthcare, insurance, or employee benefits
Strong understanding of public sector and/or labor-sponsored benefit structures, including governance, funding, and regulatory considerations
Demonstrated strength in relationship management, negotiation, and executive-level communication
Ability to synthesize financial, clinical, and operational data into clear strategic recommendations
Health & Life licensed
Arizona-based with familiarity with state and local public entities, school districts, municipalities, and labor trusts
Experience working with Taft-Hartley plans, governmental plans, or multi-stakeholder benefit environments
Track record of driving high client satisfaction while advancing cost-saving or value-based initiatives
Bachelor's degree preferred, or equivalent work experience

Job Responsibility

Serve as the senior point of contact for assigned public sector and labor accounts, building trusted relationships with plan sponsors, trustees, union leadership, and consultants
Navigate complex stakeholder environments, including elected officials, boards, labor representatives, and third-party advisors
Proactively anticipate client needs and position solutions that align with budgetary, contractual, and member priorities
Lead overall account strategy, including renewals, plan design discussions, and long-term roadmap development
Partner closely with underwriting, analytics, and clinical teams to deliver data-driven insights and actionable recommendations
Ensure contractual adherence and support clients through procurement cycles, RFPs, and governance processes unique to public and labor entities
Identify and advance opportunities to improve affordability through medical and pharmacy cost management, payment integrity, network optimization, and care management strategies
Translate complex financial and utilization data into clear, decision-ready insights for non-technical audiences
Balance cost containment with access, quality, and member experience considerations
Act as the quarterback across internal teams to ensure seamless service delivery and issue resolution

What we offer

Medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
Sales Incentive Commissions

Fulltime

New

Client Support - Representative I

The Client Support Representative I plays a critical role in delivering high-qua...

Location

United States , Work at Home

Salary:

17.00 - 28.46 USD / Hour

CVS Health

Expiration Date

May 29, 2026

Requirements

1–2 years of experience in customer service, healthcare, insurance, or benefits
Strong verbal and written communication skills
Ability to manage member issues with empathy and attention to detail

Job Responsibility

Respond to member inquiries via phone, email, or chat with professionalism and empathy
Resolve member level issues related to pharmacy benefits, claims, eligibility, and other service needs
Escalate complex cases to senior support staff as needed
Document all member interactions accurately to ensure compliance and service quality
Identify recurring issues and share feedback with leadership for process improvement
Work closely with Client Support Supervisors and Account Managers to ensure seamless service delivery
Participate in team huddles and training sessions to stay informed on product updates and policy changes
Maintain a positive and solutions-oriented approach in all member interactions
Review general team processes for accuracy and recommend updates to leadership
Engage in ongoing training to build skills in customer service, systems navigation, and healthcare knowledge

What we offer

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
bonus, commission or short-term incentive program

Fulltime

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Senior Manager, Pharmacy Benefits

Healthfirst

Location:
United States

Category:
Pharmacy

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
March 21, 2026

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Senior Manager, Pharmacy Benefits

Healthfirst

Location:United States

Category:Pharmacy

Contract Type:Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:March 21, 2026

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Job Posted:
March 21, 2026