Pharmacy Benefits Program Manager

Job Title: Pharmacy Benefits Program Manager
Client: Health Insurance Organization
Location: Baltimore, MD Hybrid (1-2 times a month)
Contract Type: Contract-to-Hire
Rate: $120/HR

Job Summary
ALTA IT Services is seeking an experienced Pharmacy Benefits Program Manager for a contract-to-hire engagement with a leading health insurance company. This role requires deep expertise in pharmacy supply chain financial management, PBM transitions, and pharmacy operations. The Program Manager will lead a major pharmacy supply chain implementation and PBM transition, overseeing execution activities, stakeholder alignment, contract and vendor management, and driving overall business readiness.

Key Responsibilities
Project Leadership & Accountability

• Lead and manage the business execution team to meet project goals, objectives, and deadlines.
• Provide strategic direction in collaboration with business sponsors, IT, PMO, and vendors.
• Make critical business decisions in partnership with leadership stakeholders.

Contracts & Vendor Management

• Negotiate and manage PBM and pharmacy supply chain contracts, including Statements of Work (SOWs).
• Monitor vendor performance, resolving issues with IT, PMO, and Operations teams to ensure successful delivery.

Value Story Development and Communication

• Develop and validate the financial and operational value story of the PBM supply chain model.
• Collaborate with executive sponsors to align on organizational impact and cost-benefit outcomes.
• Provide regular updates to stakeholders and adjust value realization strategies as needed.

Cross-Functional Collaboration & Business Readiness

• Facilitate collaboration between IT, PMO, vendors, and business units to ensure a seamless transition.
• Translate business needs into actionable requirements and ensure clear communication across teams.
• Lead meetings with stakeholders to address project status, risks, and mitigation plans.
• Support business readiness by overseeing training, documentation, and operational transition plans.

Risk Management & Performance Optimization

• Identify operational risks and implement mitigation strategies.
• Recommend process improvements for cost efficiency and service enhancement.
• Ensure business continuity and performance throughout project lifecycle.

Qualifications
Required Education & Experience:

• Bachelor's degree in Business Administration, Healthcare Management, Supply Chain, or related field.
• Minimum 7+ years in pharmacy supply chain, PBM operations, PBM contracting, or related fields.
• Experience leading PBM transitions or implementations for a health plan, PBM, or consulting firm.

In lieu of degree: An additional 4 years of relevant experience is required.
Preferred:

• MBA or Master's in a business-related discipline.

Required Skills

• Deep expertise in PBM contracting, claims adjudication, pharmacy networks, and rebate/discount financial flows.
• Knowledge of compliance frameworks and regulations impacting pharmacy operations.
• Strong strategic decision-making capabilities in complex, high-visibility environments.
• Familiarity with Medicare, Medicaid, and Commercial pharmacy benefit operations.
• Excellent verbal and written communication skills across all organizational levels.
• Strong leadership and stakeholder engagement skills, including vendor and executive management.
• Proven ability to manage large-scale, multi-functional projects in fast-paced settings.

Ref: #855-IT Baltimore
#M2