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Director/Senior Director, PBM Expert

Remote - Anywhere in the U.S. / Preferred Location: Dallas, Texas
  • Decision Making
  • PBM Operations
  • Client Interactions

We are seeking a highly skilled PBM Expert at the Director or Senior Director level to lead and innovate our Pharmacy Benefit Management (PBM) operations. This role requires a candidate with strong technical and strategic decision-making skills (50%). The candidate should be adept in PBM operations (30%) and proficient in soft skills (20%). The successful candidate will ensure operational excellence, drive innovation, and maintain high client satisfaction.

Responsibilities & Benefits
  • Technical and Strategic Decision-Making (50%)
  • Develop and implement strategic plans to deliver enhanced PBM services
  • Utilize data analytics to inform and drive data-driven decisions
  • Innovate processes and systems while leveraging digital technologies and AI
  • Ensure compliance with industry regulations and standards
  • PBM Operations (30%)
  • Oversee benefit plan design, implementation, and management
  • Optimize claims processing, eligibility, and prior authorization workflows
  • Drive continuous improvement initiatives for operational efficiency
  • Collaborate with cross-functional teams to integrate and optimize PBM solutions
  • Soft Skills (20%)
  • Manage and mentor an enthusiastic and dedicated team, fostering a culture of accountability and continuous development
  • Engage with clients to understand their needs and provide tailored solutions
  • Communicate effectively with stakeholders at all levels
  • Represent the organization in industry forums and conferences
  • Benefits
  • Competitive salary and performance-based incentives
  • Comprehensive health, dental, and vision insurance
  • Opportunities for professional development and career advancement
  • Bachelor’s degree in healthcare administration, business, or a related field; advanced degree preferred
  • 10+ years of experience in PBM operations with at least 5 years of experience in a leadership role
  • Strong technical skills in PBM systems, data analytics, and process optimization
  • Excellent leadership, communication, and interpersonal skills
  • Proven track record of driving innovation and operational excellence
  • Experience with RxClaim or similar PBM platforms
  • Certification in Six Sigma or other process improvement methodologies
  • Knowledge of AI and digital technologies in PBM operations

e-Zest is a leading digital innovation partner for enterprises and technology companies that utilizes emerging technologies for creating engaging customers experiences. Being a customer-focused and technology-driven company, it always helps clients in crafting holistic business value for their software development efforts. It offers software development and consulting services for cloud computing, enterprise mobility, big data and analytics, user experience and digital commerce.