The Company is seeking a Vice President of PBM Management to spearhead the development and execution of the pharmacy strategy for its Medicare Advantage plans. This executive will be responsible for all aspects of the pharmacy strategy, including the management of the PBM partnership, contractual obligations, formulary strategy, and overall financial performance. The role demands a leader who can ensure that pharmacy and PBM management are not just cost centers, but are, in fact, a competitive advantage. The successful candidate will work closely with the CEO of the Medicare Advantage business to shape enterprise strategy and will be expected to build and lead a high-performing team to optimize PBM performance and financial outcomes. Candidates for this role should have a proven track record in leading pharmacy strategy within a Medicare Advantage plan or a similarly complex payer environment. Deep experience in managing PBMs and pharmacy vendors, as well as a strong understanding of formulary management, PBM contract enforcement, CMS regulations, and pharmacy economics, is essential. The ideal candidate will be adept at balancing clinical quality, member experience, and financial performance, and will be comfortable influencing executives while also being detail-oriented in contract negotiation and enforcement. The role requires a strategic thinker who can continuously identify opportunities to enhance the quality, affordability, and financial performance of PBM contracts.

Hiring Company

Clover Health