Senior Director, Pharmacy and PBM Operations
Progyny
Thank you for considering Progyny!
The Pharmacy and PBM Operations Leader will oversee and manage Progyny’s pharmacy benefit management (PBM) program, driving operational excellence at both tactical and strategic levels. This role is responsible for leading end-to-end PBM and pharmacy-related operational projects, ensuring seamless integration of new programs and services, and serving as a strategic partner to leadership. The ideal candidate will possess deep industry expertise, strong leadership capabilities, and a visionary mindset to drive innovation and continuous improvement in a dynamic, high-growth environment.
What you'll do...
Oversee and manage key PBM/pharmacy programs, providing operational leadership at both tactical and strategic levels.
Develop, support, and execute end-to-end lifecycle of PBM/pharmacy-related operational projects and deliverables.
Serve as the primary contact for PBM/pharmacy trading partners.
Implement and enhance operational processes to improve efficiency, accuracy, and customer satisfaction.
Collaborate with cross-functional teams for seamless integration of new programs and services.
Monitor and analyze key performance indicators to identify areas for improvement and optimization.
Act as a thought partner, sounding board, and strategic advisor to Progyny leadership and cross-functional partners.
Provide analysis, recommendations, and options regarding high-impact decisions.
Support the rebate management process from both trading partner and employer client perspectives.
About you...
12+ years of extensive experience in PBM operations, including interaction with self-funded and employer-sponsored health plan benefits.
Doctor of Pharmacy preferred.
Knowledge of accreditation standards (URAC, ACHC) is a plus.
Comprehensive knowledge of PBM/pharmacy/healthcare industry, PBM operations, third party administrators, benefit setup (ASO and fully-insured), pharmacy claims, and managed care.
Strong understanding of PBM processes: claims adjudication, network development, pricing, analytics/reporting, rebates, clinical aspects, trade, contracting, systems, and account management.
Experience negotiating contracts with PBMs and pharmacies.
Visionary mindset with the ability to anticipate and navigate emerging changes in the healthcare landscape and identify innovative solutions to complex challenges.
Exceptional communication skills to convey complex PBM/pharmacy concepts to diverse stakeholders, fostering clear understanding and driving organizational success.
Proven change agent with the ability to initiate and lead initiatives, motivate teams, and foster a culture of adaptability, high performance, accountability, excellence, and continuous improvement.
High proficiency in project management methodologies for effective planning, execution, and monitoring of key initiatives, ensuring timely delivery of results.
Strong analytical and problem-solving skills with attention to detail for addressing complex operational challenges.
Ability to manage expectations and facilitate understanding at all organizational levels, both internally and externally.
Capacity to lead, oversee, prioritize, and handle multiple projects and clients with dynamic and shifting timelines, utilizing proven project management processes.
Demonstrated success in driving operational excellence and executing process improvements in a high-growth, fast-paced, entrepreneurial business setting, with a focus on measuring results and achieving targeted outcomes.
Progyny (Nasdaq: PGNY) is a global leader in women’s health and family building solutions, trusted by the nation’s leading employers, health plans and benefit purchasers. We envision a world where everyone can realize dreams of family and ideal health. Our outcomes prove that comprehensive, inclusive and intentionally designed solutions simultaneously benefit employers, patients and physicians.
Our benefits solution empowers patients with concierge support, coaching, education, and digital tools; provides access to a premier network of fertility and women's health specialists who use the latest science and technologies; drives optimal clinical outcomes; and reduces healthcare costs.
Our mission is to empower healthier, supported journeys through transformative fertility, family building and women’s health benefits.
Headquartered in New York City, Progyny has been recognized for its leadership and growth as a TIME100 Most Influential Company, CNBC Disruptor 50, Modern Healthcare's Best Places to Work in Healthcare, Forbes' Best Employers, Financial Times Fastest Growing Companies, Inc. 5000, Inc. Power Partners, and Crain's Fast 50 for NYC. For more information, visit www.progyny.com.
Our perks:
- Family friendly benefits: Paid family and parental leave, preconception, fertility and family building benefits (including egg freezing, IVF, and adoption support), family and pet care fund, and Parents’ Employee Affiliation Group
- Menopause and midlife care
- Health, dental, vision and life insurance options for employees and family
- Free in-person, virtual and text-based mental health and wellness support
- Paid time off, including vacation, sick leave, personal days and summer flex time
- Company equity
- Bonus program
- 401(k) plan with company match
- Access to on-demand legal and financial advice
- Learning and development programs to help you grow professionally and a mentorship program
- Company social events to include annual volunteer day and donation matching
- Flex days (3 days a week in the office) and onsite meals and snacks for employees reporting into our NY office
In compliance with New York City's Wage Transparency Law, the annual salary [wage] range for NYC-based applicants is: $165,000 - $195,000. There are a variety of factors that go into determining a salary range, including but not limited to external market benchmark data, geographic location, and years of experience sought/required. Progyny offers a total compensation package comprised of base salary, cash bonus, and equity.
Progyny is proud to be an Equal Opportunity and Affirmative Action employer. We respect and seek to empower each individual and support the diverse cultures, perspectives, skills and experiences within our workforce. All qualified applicants will receive consideration for employment without regard to race, creed, color, religion, sex, sexual orientation, gender identity or expression, national origin, disability, age, genetic information, marital status, pregnancy or related condition, status as a protected veteran, criminal history consistent with legal requirements or any other basis protected by law.
If you are an individual with a disability and need assistance or an accommodation during the recruiting process, please send an e-mail to apply@progyny.com.