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Senior Project Manager, Pharmacy Value Programs

2 months ago
United States
Full-time
Senior
Project Manager
Project and Program Management
CRM JIRA Python Salesforce SQL
Apply Now
Capital Rx

Capital Rx

Capital Rx provides comprehensive health benefit management and transparent pharmacy benefit management solutions, integrating various healthcare services to support millions of plan members across diverse sectors.

Health Care Providers & Services
251-1K
Founded 2017
View All Jobs 34

Description

  • Develop and maintain drug cost containment programs across Commercial, Exchange, Medicare, and Medicaid lines of business.
  • Plan and execute program implementations with internal stakeholders and cross-functional teams.
  • Maintain implementation plans, workflow guides, training materials, and related documentation.
  • Establish quality control processes, conduct audits, and implement corrective actions to ensure compliance.
  • Manage third-party vendor and pharmacy partner relationships for program administration, cost savings, and member experience.
  • Partner with Analytics to create opportunity analyses and ongoing savings performance reports.
  • Support go-to-market activities for savings products, including pricing, marketing enablement, and implementation support.
  • Contribute to RFI and RFP responses for new offerings.
  • Evaluate market trends and prescription claims data to identify improvement opportunities and support new product development.
  • Support continuous quality improvement initiatives as needed.

Requirements

  • Bachelor’s degree is required.
  • 4+ years of experience in healthcare cost management or a related environment such as health plans, PBMs, value-based care, managed care, consulting, advisory, or tech enablement.
  • Ability to manage multiple complex projects simultaneously with minimal direction.
  • Strong time management and organizational skills.
  • Exceptional written, verbal, and presentation skills.
  • Experience working with data reporting tools and interpreting data analyses, reports, and visualizations.
  • Master’s degree in a relevant field such as PharmD, MBA, or MHA/MHP is preferred.
  • Experience with prescription drug channels and payment workflows, including pharmacy reimbursement, rebate administration, GPO relations, and regulatory requirements, is preferred.
  • Experience with health insurance or health benefits administration, especially pharmacy benefits, is preferred.
  • Experience using workflow and data management tools such as CRM systems, Jira, Salesforce, and collaborative Excel workbooks in SharePoint is preferred.
  • Experience with SQL or Python is preferred.
  • Proficiency in Microsoft Office Suite, especially Excel and PowerPoint, is preferred.
  • Ability to think strategically, identify inefficiencies, and improve processes through automation and redesign is preferred.
  • Highly detail-oriented and analytical mindset is preferred.
  • Ability to travel occasionally for internal, client, vendor, and partner meetings is preferred.

Benefits

  • Remote, US salary range of $93,200 to $147,000 USD.
  • New York, NY salary range of $117,600 to $147,000 USD.
  • Denver, CO salary range of $108,000 to $135,000 USD.

Interested in this position?

Apply directly on the company website

Apply Now

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