Position Summary

The Market Access Programs Senior Project Manager will lead the development, execution, and continuous improvement of innovative market access programs across all lines of business, including Commercial, Exchange, Medicare, and Medicaid. In this highly cross‑functional role, the Program Manager partners closely with internal teams, external vendors, and pharmacy partners to design and implement strategic initiatives—from specialty pharmacy partnerships to manufacturer‑direct solutions—that enhance member experience and reduce overall drug spend. This role is responsible for maintaining detailed implementation plans, operational workflows, and training materials while ensuring program quality and compliance through structured audits and documentation. The Project Manager also collaborates with Analytics to produce opportunity assessments and savings reporting, and supports the commercialization of new offerings through pricing, marketing enablement, and RFI/RFP contributions. The ideal candidate brings deep experience in healthcare cost management, strong analytical capabilities, exceptional communication skills, and a strategic mindset with the ability to identify inefficiencies and drive long‑term product and process improvements in a fast‑paced environment.

Position Responsibilities:

• Program Development & Management: Collaborate with key stakeholders to develop and maintain new and existing market access programs for all relevant lines of business. Programs include, but are not limited to, innovative pharmacy network configurations and partnerships with supply chain stakeholders.
• Program Planning and Execution: Engage with appropriate stakeholders and cross-functional teams to ensure successful implementation and execution of programs.
• Program Maintenance: Regularly update and maintain comprehensive implementation plans, workflow guides, trainings, rules sets, and other documentation as relevant and required.
• Quality Assurance: Implement quality control processes to ensure program compliance with established standards and guidelines. Conduct and document audits and work with appropriate stakeholders to implement corrective actions as needed.
• Vendor management: Own relationship with and provide oversight of third-party vendors and/or partners (pharmacy providers or manufacturers) to administer programs with emphasis on member experience and value capture for clients.
• Data Analytics & Reporting: Use reporting tools and partner with our Analytics team to develop and maintain opportunity analyses and ongoing savings performance reporting.
• Commercialization: Support the go-to-market strategy of program offerings including pricing, marketing, and implementation. Support RFI and RFP submissions.
• Continuous quality improvement: Evaluate evolving industry and market landscape and analyze prescription claims data to identify opportunities for improving existing programs and developing new programs and/or partnerships. Supports quality improvement programs/projects as required. 

Required Qualifications:

• Bachelor’s Degree required
• 4+ years of experience applicable to health care,, such as in a health plan, PBM, pharmacy, manufacturer, value-based care, or managed care environment; consulting, advising, or tech enablement focused on the preceding areas also considered applicable
• Ability to balance multiple complex projects simultaneously with minimal direction
• Great time-management and organizational skills to manage multiple active projects simultaneously
• Exceptional written, verbal, and presentation skills
• Experience working with data reporting tools, conducting data analyses, and effectively consuming/interpreting data reports and visualizations

Preferred Qualifications:

• Master’s Degree in relevant field (PharmD, MBA, MHA/MHP, etc.)
• Experience with prescription drug channels and payment workflows (pharmacy reimbursement, rebate administration and GPO relations, regulatory requirements, etc.)
• Experience with health insurance or health benefits administration (pharmacy benefits in particular)
• Strong experience in developing, implementing, and using data and workflow management technology solutions (e.g., customer relationship management (CRM), Jira/Salesforce, collaborative Excel workbooks in SharePoint, etc.)
• Experience with programming languages relevant to data analytics, such as SQL or Python
• Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and PowerPoint
• Ability to think strategically and identify inefficiencies, develop long-term solutions, and challenge and improve existing processes through automation and redesign
• Highly detail-oriented and analytical
• Ability to travel occasionally as needed for internal, client, and vendor/partner meetings