Team Leader - Pharmacy Business Support (PBM Oversight)

Company Description

Why Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today! 

Learn more about our unique benefit offerings here. 

Job Description

Use your strengths at Wellmark as a Team Leader of Pharmacy Business Support!    

As a Team Leader of Pharmacy Business Support, you will lead and develop a growing Pharmacy Performance team dedicated to ensuring rigorous oversight of Wellmark’s Pharmacy Benefits Manager (PBM) and other pharmacy vendors.  

With your strong communication skills and ability to effectively build professional partnerships across an organization and externally, you are energized by the idea of enhancing our vendor oversight to a state of maturity. You think critically to identify process gaps, risks, efficiencies and trends. You have a unique ability to influence others in a collaborative manner.  

As a leader of others, you will directly impact the success, growth, and development of team members by setting clear expectations, defining accountabilities, providing regular coaching, facilitating change, and providing an overall positive work environment. Being a role model in behaviors that demonstrate Wellmark’s Leader Success Expectations is a must. You are a strong change leader who demonstrates both flexibility and resiliency. You are at your best when you can strategically think both up and downstream, use data to inform decisions, and creatively solve problems – plus, you love to inspire and coach others to do the same. 

The work won’t be easy, but you are excited about the opportunity to join a growing, highly visible area of the business focused on the total cost of health care. 

This position will work a hybrid schedule of at least 3 days in Wellmark's Des Moines office, with 2 days remote option. As a leader, there may be additional days in the office to meet business needs.

Qualifications

Preferred Qualifications - Great to have:

• MBA or advanced degree in a related field.
• Experience working with vendor’s such as CVS or other PBMs in a health plan setting.
• Familiarity with Medicare Part D, compliance frameworks, and pharmacy data systems.
• Formal people-leadership experience.

Required Qualifications - Must have:

• Bachelor’s degree in business, health care administration, or related field, or equivalent experience.
• 4+ years of experience in health insurance, Operations, PBM, or pharmacy benefit administration.
• Demonstrated leadership experience with cross-functional or matrixed teams. Ability to operate with agility and flexibility; effectively moves from strategy to tactics to operations.
• Leadership experience gained through a combination of project or informal leadership.
• Strong understanding of pharmacy benefit design, claims processing, and vendor oversight.
• Ability to measure, evaluate and/or improve work processes, programs, and services; ensures alignment with strategic goals.
• Strong written and verbal communication skills with the ability to effectively communicate information to varying audiences, including vendor partners.
• Understanding of applicable rules, regulations, and guidelines. Must be aware of implications to department.
• Strong consulting and critical thinking skills with the ability to provide insights and recommendations, influence others to action, and produce customer-focused solutions.
• Effective time management and organizational skills with the ability to prioritize initiatives, align appropriate resources, clearly articulate expectations to others, and motivate teams in order to achieve success.
• Adaptable and flexible with change and also have the ability to effectively lead teams through change.

Additional Information

What you will do as a Team Leader - Pharmacy Business Support:

a. Provide leadership and day-to-day management of financial and human resources, primarily focusing on employee coaching, development, performance improvement, coordination and budgeting for staff and department(s) specific functions/services.

b. Support business objectives and produce results that are effective, accurate, timely, and on target to meet business and stakeholder needs. Identify, monitor and communicate critical business metrics to ensure project execution success and leverage results for future process improvements.

c. Serve as a primary liaison with CVS for non-clinical aspects of the pharmacy benefit, ensuring accurate implementation of Wellmark’s business requirements.

d. Oversee quality assurance, compliance monitoring, and performance tracking related to PBM services and internal pharmacy support functions.

e. Cascade and communicate operational strategy and initiatives to team members, driving customer/ stakeholder service, supporting achievement of overall company results.

f. Collaborate with the Pharmacy Product team to inform product strategy, contribute to roadmap planning, and provide subject matter expertise.

g. Ensure adherence to contractual, regulatory, and accreditation standards (e.g., CMS, HEDIS, NCQA) through effective oversight and documentation.

h. Support enterprise initiatives by representing non-clinical pharmacy perspectives in cross-functional workgroups and strategic planning efforts.

i. Promote a culture of accountability, innovation, and service excellence across the team.

j. Partner with internal stakeholders (e.g., Compliance, Legal, Product, and Technology) to ensure timely resolution of issues and alignment with enterprise priorities.

k. Monitor and analyze performance metrics to identify trends, risks, and opportunities for improvement.

l. Contribute to the development and maintenance of policies, procedures, and training materials to support consistent and compliant execution of responsibilities.

m. Other duties as assigned.

This job requires a non-compete agreement.

An Equal Opportunity Employer

The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.

Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at careers@wellmark.com

Please inform us if you meet the definition of a "Covered DoD official".

At this time, Wellmark is not considering applicants for this position that require any type of immigration sponsorship (additional work authorization or permanent work authorization) now or in the future to work in the United States. This includes, but IS NOT LIMITED TO: F1-OPT, F1-CPT, H-1B, TN, L-1, J-1, etc. For additional information around work authorization needs please refer to the following resources:Nonimmigrant Workers and Green Card for Employment-Based Immigrants 

Wellmark supports and expects the responsible use of AI for our workforce! We welcome the responsible use of these tools by job seekers as well and are interested in learning from you; you will have an opportunity in the application process to share which tools you used and how you applied them.