VP, PBM

Overview

Remote
$220000
Full Time

Job Details

Hiring a VP of PBM for a startup healthcare client

100% remote in US only

Duties/Responsibilities:

  • Lead the development and launch of Company’s in-house Pharmacy Benefit Manager (PBM), defining the vision, strategy, and roadmap to transition from external vendors to internal operations.

  • Manage the strategic shift from outsourced PBM services, ensuring a seamless, cost-effective transition with minimal service disruption.

  • Oversee core PBM functions: claims adjudication, pharmacy contracting, formulary management, DUR, prior authorization, specialty pharmacy services, and P&T Committee coordination.

  • Prepare PBM BID files for CMS submission and coordinate timely delivery to the Product Manager.

  • Ensure compliance with all federal and state regulations, including Medicare Part D, and manage internal controls, audits, and reporting.

  • Recruit, build, and lead a high-performing PBM team focused on excellence, accountability, and continuous improvement.

  • Develop strategic partnerships with manufacturers, pharmacy networks, and internal teams to support access, affordability, and clinical outcomes.

  • Implement innovative pricing, rebate, and contracting strategies to optimize cost savings while maintaining quality.

  • Promote service excellence by adopting best practices and technologies to enhance member experience, improve efficiency, and reduce costs.

  • Perform additional duties and special projects as assigned.

Required Skills/Abilities:

  • Deep knowledge of PBM operations, rebate structures, formularies, and cost-containment strategies.

  • Strong grasp of healthcare regulations and pharmacy compliance.

  • Financial expertise, including pricing strategy and P&L management.

  • Proven leadership of cross-functional teams and complex initiatives.

  • Strong communication, negotiation, and relationship-building skills.

  • Excellent time management, attention to detail, and problem-solving abilities.

Education and Experience:

  • Bachelor’s in business, healthcare administration, pharmacy, or related field (MBA or advanced degree preferred).

  • Minimum 5 years of Medicare Part D experience.

  • Pharmacist background preferred.

  • At least 5 years in leadership roles with demonstrated success in pharmacy pricing and negotiation.

  • Expertise in pharmacy operations, technology, and vendor management.

  • Proven record of strategic planning and innovation.



Determining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual’s skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs. With that said, as required by local law in geographies that require salary range disclosure, Vaco/Highspring notes the salary range for the role is noted in this job posting. The individual may also be eligible for discretionary bonuses, and can participate in medical, dental, and vision benefits as well as the company’s 401(k) retirement plan.
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