Now is the time to join us! 

Who are you?

The PBM Operational Liaison will be responsible for managing and coordinating all operational aspects of the Pharmacy Benefit Manager (PBM) interface for our mutual clients. This role involves ensuring compliance with legal and contractual obligations, managing data exchanges, addressing operational issues, and maintaining strong vendor relationships. The liaison will work closely with internal teams, including tech ops, data engineering, and pharmacy strategy along with account management , to ensure seamless operations and timely resolution of any discrepancies or issues.

In this role you will wear many hats, but your knowledge will be essential in the following:  

• Vendor Management: Build and maintain strong relationships with technical operations within PBMs, ensuring effective communication and collaboration. Partner with Pharmacy Strategy to negotiate file formats and data exchange standards, and ensure PBMs adhere to agreed-upon technical processes. Clarify and establish distinct responsibilities between the PBM and Personify Health to ensure seamless client service.
• Operational Coordination: Oversee the daily operations of PBM interface , focusing on data exchanges, compliance requirements, and resolving operational challenges. Collaborate with internal teams to ensure seamless operations and prompt issue resolution. Specifically, work with technical operations teams to ensure files are in production with positive confirmation for both inbound and outbound data transfers and follow up on any break/fix situations. Ensure all feedback files are reviewed and worked utilizing data management tools to track completion and identify trends.
• Sales Liaison: Ensure the sales team is well-informed about managing client expectations during the sales process. Emphasize the importance of understanding the products and services being sold, as well as the choices clients make regarding preferred or partnered PBMs versus selecting their own. Additionally, review sales contracts to confirm the feasibility of any custom requests and participate in deal desk reviews.
• Implementation Support: Work closely with the implementation team to ensure all legal documents are completed and requirements are defined before engaging with PBMs. Manage new vendor setups and ensure compliance with data sharing agreements.
• Feedback and Validation: Validate and confirm data files, ensuring that any issues or discrepancies are addressed promptly. Manage feedback from PBMs and coordinate with tech ops to resolve any data-related issues.
• Compliance and Reporting: Ensure compliance with legal and contractual obligations, including data sharing agreements and reporting requirements. Provide regular updates and reports to internal stakeholders on the status of PBM relationships and any operational issues.
• Process Improvement: Identify opportunities for process improvement and implement best practices to enhance the efficiency and effectiveness of PBM operations. Collaborate with internal teams to develop and implement new processes and procedures.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

What you bring to the Personify Health team:

In order to represent the best of what we have to offer you come to us with a multitude of positive attributes including:

• Bachelor's degree in Business Administration, Healthcare Management, or a related field.
• Minimum of 5 years of experience in PBM operations, vendor management, or a related role.
• Strong understanding of PBM operations, data file formats and respective data dictionaries, data exchanges, and compliance requirements.
• Excellent communication and interpersonal skills, with a proven ability to build and maintain strong vendor relationships.
• Strong problem-solving and analytical skills, with the ability to identify and resolve operational issues while confidently liaising between our internal technical teams and PBM technical teams.
• Ability to work independently and manage multiple priorities in a fast-paced environment.
• Experience with data management systems

You also take pride in offering the following Core Skills, Competencies, and Characteristics:

• Experience working in a PBM, healthcare or insurance environment
• Deep operational knowledge of PBM data file exchange and operational efficiency.
• Knowledge of legal and regulatory requirements related to PBM operations.
• Experience with project management and process improvement methodologies.

No candidate will meet every single desired qualification. If your experience looks a little different from what we’ve identified and you think you can bring value to the role, we’d love to learn more about you!

Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.

In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $100,000 to $120,000. Note that compensation may vary based on location, skills, and experience. This position is eligible for 15% target bonus/variable compensation as well as health, dental, vision, mental health and other benefits.

We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.

#WeAreHiring #PersonifyHealth

Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to talent@personifyhealth.com. All of our legitimate openings can be found on the Personify Health Career Site.

Application Deadline: Open until position is filled.