Vaco
100% remote in US, EST Hours
Overview:
Hiring a VP, Pharmacy Operations that will have a strategic focus on formulary strategy, Medicare Part D compliance, reporting and performance management. Opportunity to create processes and procedures from the ground up Responsibilities:
Ensure full compliance with federal and state healthcare regulations, including CMS requirements for Medicare Part D, while managing internal controls, reporting, and audit processes to maintain regulatory readiness. Attract, build, and lead a high-performing PBM team, fostering a culture of excellence, accountability, and continuous improvement to meet strategic, operational, and financial goals. Develop and oversee all core PBM functions, including claims adjudication, pharmacy network contracting, formulary design and management, drug utilization review (DUR), prior authorization protocols, specialty pharmacy services, and coordination with the Pharmacy & Therapeutics (P&T) Committee. Establish strategic partnerships with pharmaceutical manufacturers, pharmacy networks, and internal stakeholders to support access, affordability, and clinical effectiveness. Design and implement innovative pricing, rebate, and contracting strategies to optimize cost savings and deliver value-based pharmacy care without compromising quality. Champion service excellence and innovation, identifying and integrating industry best practices, technologies, and clinical programs to improve member experience, drive operational efficiency, and reduce pharmacy spending. Required Skills:
Strong knowledge of PBM business models, rebate structures, formularies and cost management strategies. Excellent understanding of healthcare regulatory compliance and pharmacy laws. Strong financial acumen with the ability to develop pricing strategies and manage P&L. Demonstrated ability to lead cross-functional teams and drive large-scale initiatives. Education and Experience:
Bachelor's Degree in Pharmacy/PharmD Must have strong Medicare Part D experience 5+ years of leadership-level experience and documented record of success in pharmacy pricing negotiations Knowledgeable and experienced in Pharmacy operations, systems, technology, and vendors Strong financial acumen and PBM knowledge (pricing, rebate, formulary) Vaco by Highspring values a diverse workplace and strongly encourages women, people of color, LGBTQ+ individuals, people with disabilities, members of ethnic minorities, foreign-born residents, and veterans to apply. Vaco by Highspring is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race (including but not limited to traits historically associated with race such as hair texture and hair style), color, sex (includes pregnancy or related conditions), religion or creed, national origin, citizenship, age, disability, status as a veteran, union membership, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, political affiliation, or any other protected characteristics as required by federal, state or local law.
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Hiring a VP, Pharmacy Operations that will have a strategic focus on formulary strategy, Medicare Part D compliance, reporting and performance management. Opportunity to create processes and procedures from the ground up Responsibilities:
Ensure full compliance with federal and state healthcare regulations, including CMS requirements for Medicare Part D, while managing internal controls, reporting, and audit processes to maintain regulatory readiness. Attract, build, and lead a high-performing PBM team, fostering a culture of excellence, accountability, and continuous improvement to meet strategic, operational, and financial goals. Develop and oversee all core PBM functions, including claims adjudication, pharmacy network contracting, formulary design and management, drug utilization review (DUR), prior authorization protocols, specialty pharmacy services, and coordination with the Pharmacy & Therapeutics (P&T) Committee. Establish strategic partnerships with pharmaceutical manufacturers, pharmacy networks, and internal stakeholders to support access, affordability, and clinical effectiveness. Design and implement innovative pricing, rebate, and contracting strategies to optimize cost savings and deliver value-based pharmacy care without compromising quality. Champion service excellence and innovation, identifying and integrating industry best practices, technologies, and clinical programs to improve member experience, drive operational efficiency, and reduce pharmacy spending. Required Skills:
Strong knowledge of PBM business models, rebate structures, formularies and cost management strategies. Excellent understanding of healthcare regulatory compliance and pharmacy laws. Strong financial acumen with the ability to develop pricing strategies and manage P&L. Demonstrated ability to lead cross-functional teams and drive large-scale initiatives. Education and Experience:
Bachelor's Degree in Pharmacy/PharmD Must have strong Medicare Part D experience 5+ years of leadership-level experience and documented record of success in pharmacy pricing negotiations Knowledgeable and experienced in Pharmacy operations, systems, technology, and vendors Strong financial acumen and PBM knowledge (pricing, rebate, formulary) Vaco by Highspring values a diverse workplace and strongly encourages women, people of color, LGBTQ+ individuals, people with disabilities, members of ethnic minorities, foreign-born residents, and veterans to apply. Vaco by Highspring is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race (including but not limited to traits historically associated with race such as hair texture and hair style), color, sex (includes pregnancy or related conditions), religion or creed, national origin, citizenship, age, disability, status as a veteran, union membership, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, political affiliation, or any other protected characteristics as required by federal, state or local law.
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