Senior Implementation Consultant - Pharmacy Benefit Manager

Keep in mind this is specifically for someone with PBM SYSTEM implementations. Best to find someone that is doing something similar to what carefirst is doing replacing their current Caremark system with a new PBM System. Must have strong business knowledge with PBMs.

Job Description:-

we are looking for a very senior resource

Summary:

Client is looking for a Senior PBM Strategy and Implementation Consultant to support the implementation of a new pharmacy benefits manager (PBM) and financial model. This role will report directly to the VP of Pharmacy Management and serve as the business lead throughout an 18-month implementation process. The consultant will work cross-functionally with internal stakeholders, including IT, project management, operations, and external implementation vendors. Responsibilities include ensuring project deliverables are met, managing execution and alignment, and collaborating with both incumbent and new PBM vendors.

Required:

Experience in project leadership and execution in matrix environments

Direct experience with Pharmacy Benefit Manager implementations (hands-on, not advisory only)

Strong understanding of the Pharmacy Benefit Manager industry: financial models (discounts, rebates), operations (formulary, claims adjudication, network mgmt.)

Experience supporting pharmacy benefits in a Commercial line of business (required, Medicare and Medicaid are a plus)

Nice to have:

Experience across Medicare, Medicaid, and commercial lines of business

Previous roles with health plans or PBMs