Pharmacy Benefits Program Manager

Position Summary / Career Interest:

The Pharmacy Manager for Pharmacy Benefit Programs fulfills a leadership and subject matter expert role by managing key operational and strategic aspects of the organization's employee pharmacy benefit programs. This position requires strong leadership, analytical, and communication skills, as well as the ability to collaborate professionally with Total Rewards (HR), Finance, PBM vendors, clinical stakeholders, and employees. The Pharmacy Manager for Pharmacy Benefit Programs is responsible for supporting the design, implementation, and day‑to‑day management of pharmacy benefit initiatives, including formulary customization and management, that follow evidence‑based guidelines, support a positive member experience, and contribute to the financial sustainability of the benefit. This role ensures the pharmacy benefit is clinically sound, financially sustainable, and delivers an exceptional member experience.

Responsibilities and Essential Job Functions

• Provides leadership and accountability for the performance, quality, and outcomes of the employee pharmacy benefit program.
• In conjunction with Total Rewards leadership, oversees the development, implementation, and ongoing governance of pharmacy benefit plan design strategies that follow evidence‑based clinical guidelines, optimize member experience, and promote financial sustainability.
• Leads the development, implementation, and ongoing oversight of a customized formulary strategy that integrates evidence‑based clinical decision‑making with financial stewardship to achieve the lowest net cost while ensuring safe, effective, and appropriate access to medications for plan members.
• Leads program‑level evaluation of pharmacy benefit performance, including utilization trends, cost drivers, and clinical outcomes, to identify opportunities for optimization and cost containment.
• Applies appropriate clinical, financial, and analytical frameworks to inform short‑ and long‑term pharmacy benefit decisions and strategy.
• Reviews, validates, and synthesizes pharmacy benefit analyses, reports, and recommendations to support leadership decision‑making.
• Provides oversight of vendors who support the pharmacy benefit, including the Pharmacy Benefit Manager (PBM), through management of vendor performance, contract compliance, and issue management; directs corrective actions and escalates concerns as needed.
• Leads pharmacy benefit implementations, benefit changes, and annual planning cycles, ensuring readiness, risk mitigation, and cross‑functional alignment.
• Partners with Total Rewards, Finance, Legal, and Compliance teams to ensure pharmacy benefit programs meet organizational objectives, governance standards, and regulatory requirements.
• Serves as the pharmacy benefit subject matter expert, clearly communicating program strategy, risks, and recommendations to leadership, Total Rewards, and key stakeholders.
• Collaborate with communications and Total Rewards teams to develop clear, effective member education and change communications.
• Serve as the pharmacy benefit subject matter expert for executive leadership, Total Rewards, and clinical partners.
• Identifies opportunities for continuous improvement and leads initiatives to strengthen benefit effectiveness, operational efficiency, and stakeholder satisfaction.
• Establishes priorities, work plans, and performance expectations for the Pharmacy Benefit Program Coordinator; provides guidance, mentorship, and review of work products.
• Supports the professional development of direct reports and maintains personal competency in pharmacy benefit management and leadership.
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
• These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education and Experience

• Bachelor of Science in Pharmacy OR
• Pharmacy Doctorate in Pharmacy
• 2 or more years in a formal leadership role
• 3 or more years in pharmacy benefits, managed care, PBM, health plan, or employer‑based pharmacy settings

Preferred Education and Experience

• Master Health Care Management OR
• Masters Business Administration
• Completion of an ASHP accredited PGY-1 in Managed Care

Required Licensure and Certification

• Licensed Pharmacist - State Board of Pharmacy in state of primary practice site within 120 Days

Preferred Licensure and Certification

• Certified Managed Care Pharmacist (CMCP)

We are an equal employment opportunity employer without regard to a person’s race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status or genetic information.