The Operations Manager will oversee day-to-day PBM operations, focusing on process optimization, client service excellence, and organizational scalability. This role requires a deep understanding of PBM functions, including pharmacy networks, claims processing, formulary management, prior authorizations, and compliance requirements. The ideal candidate will thrive in a high-growth environment, bringing operational expertise and a passion for building efficient, client-focused systems.

Key Job Responsibilities:

• Overseeing client implementation
• Monitor key performance indicators (KPIs) and service level agreements (SLAs) to ensure operational efficiencies and quality
• Leading PBM-related projects
• Managing vendor relationships
• Foster a positive and productive work environment
• Ensuring compliance with regulation
• Analyzing operational data to identify areas for improvement
• Collaborating with internal teams to support sales and client services.
• Troubleshoot and resolve complex operational issues.

Requirements:

• Minimum of 5-7 years of experience in Pharmacy Benefit Management (PBM) operations.
• Minimum of 3-5 years of experience in a leadership or management role.
• Proven track record of managing and improving operational workflow
• Strong knowledge of PBM systems and claims adjudication software.
• Familiarity with pharmacy claims processing standards (e.g., NCPDP D.0).
• Experience in a growth-stage or startup PBM environment.
• Lean Six Sigma or similar process improvement certifications.
• Familiarity with PBM claims adjudication platforms, formulary management, and network contracting.

About Unified Labor Rx

At Unified Labor Rx, organized labor is both a client and a partner – our success is your success. Our goal is to achieve the best balance between cost and efficacy for both members and plans, which is why we pursue any and all solutions in an integrated way. If there’s a way to reduce costs without compromising patient outcomes, we’ll pursue it aggressively and competently.

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