Pharmacy Solutions Manager

🔥 0 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🟠 Senior

🔴 Lead

💻 Solutions Engineer

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Liviniti

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2011

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare • Healthcare Insurance • Pharmaceuticals

Liviniti is a pass-through pharmacy benefit manager (PBM) that helps employers and health systems reduce prescription drug costs through transparent pricing, clinical programs, and drug sourcing. The company offers 100% rebate pass-through, a flat administrative fee, access to claims and rebate details for full visibility, customizable formularies and networks, prior authorization focused on lowest net cost, and specialized solutions like LivLite for managing GLP‑1 weight-loss drugs. Liviniti emphasizes B2B service, clinical value, and continuous innovation to lower pharmacy spend while maintaining member support and service.

📋 Description

• Lead onboarding and setup of Health System owned/affiliated pharmacies, including participation records, credentialing documentation, system configuration, and Payment-Remit setup communications • Validate pharmacy data and setup accuracy through quality checks and audits, correcting discrepancies affecting claims, payments, or reporting • Lead pharmacy-partner communications, collect and maintain pharmacy records, agreements, and correspondence • Resolve escalated pharmacy participation and communication issues and serve as a trusted point of contact for pharmacy partners • Participate in implementation meetings and communicate timelines, problems, questions, and pertinent information • Assist with development, rollout, and ongoing management of specialized pharmacy programs and provider communications • Support network strategy, RFP responses, new client implementations, access analyses, gap analyses, and disruption analyses • Partner with Clinical, Operations, Account Management, and Network teams across the client lifecycle • Develop SOPs, workflows, job aids, and internal training materials; implement process improvements • Produce pharmacy-specific reporting and actionable insights on participation, performance, and program impact • Track department ticket queues, monitor service levels and guarantee items, flag risks, and drive corrective action • Ensure regulatory, contractual, and HIPAA compliance; report HIPAA violations and complete required HIPAA training • Provide leadership and oversight for the department, including supervision of managers and directors • Travel approximately 30%

🎯 Requirements

• Active pharmacist licensure • Doctor of Pharmacy (PharmD) • Minimum seven years of progressive experience in pharmacy network operations, PBM operations, managed care, healthcare compliance, regulatory affairs, audit management, or related areas • Two years of relevant PBM experience • Hospital health system experience • Experience managing regulatory submissions, audits, corrective action plans, compliance monitoring, or regulator-facing responses • Proven ability to work cross-functionally with Legal, Compliance, Operations, IT, Network, and senior leadership • Project management and organizational rigor • Technical capacity • Problem solving and analysis • Strong written and spoken communication • Self-learning ability • Cross-functional collaboration • Program and process development and oversight • Ability to work core hours from 8:00 AM to 5:00 PM CT and adjust work times for meetings across time zones • Ability to work extended hours, weekends, and holidays as industry demands • Preferred: Bachelor’s degree in a related field • Preferred: two years’ experience in a health care related field • Preferred: two years’ experience in business analysis • Preferred: advanced degree such as MBA, MHA, PharmD, JD, or related graduate degree • Preferred: healthcare compliance, pharmacy technician, or related professional certification • Strongly preferred: PBM, health plan, managed care, pharmacy network, or regulator-facing experience • Preferred: leadership experience building or improving compliance programs, audit processes, tracking tools, or governance frameworks

🏖️ Benefits

• Medical, Dental and Vision Insurance • Disability and Life Insurance • Employee Assistance Program • Remote work options • Generous Paid-Time off • Annual reviews and development plans • Retirement Plan with company match immediately 100% vested