Pharmacy Solutions Manager - REMOTE

The Pharmacy Solutions Manager is a licensed pharmacist responsible for driving the implementation, oversight, functionality, and quality assurance of pharmacy programs across Liviniti Health’s network Health System pharmacies. This role serves as a key point of connection between Health System pharmacy partners and internal team-leading communications, resolving escalated issues, and supporting new programs, network strategy, and client implementations. The Pharmacy Solutions Manager develops scalable processes and procedures, delivers pharmacy-specific reporting, and provides the specialized support needed to manage and grow the network with accuracy, consistency, and excellence. The Pharmacy Solutions Manager is required to perform the following duties and professionally undertakes the following responsibilities:

Pharmacy Onboarding, Setup, & Data Integrity

• Lead the onboarding and setup of Health System owned/affiliated pharmacies, ensuring accurate participation records, credentialing documentation, and system configuration.
• Lead and assist with all required Payment-Remit set up communications.
• Validate pharmacy data and set up accuracy through routine quality checks and audits, correcting discrepancies before they impact claims, payments, or reporting.
• Lead communications with Health System owned/affiliated pharmacies to collect, document, and store relevant documents.
• Maintain a centralized, current repository of pharmacy records, agreements, and communications, ensuring documents are complete, organized, and readily retrievable.

Communications & Issues Resolution

• Lead and resolve escalated issues related to pharmacy participation status and pharmacy communications.
• Take an external/internal role in communication with pharmacy partners.
• Serve as a trusted point of contact for pharmacy partners, building strong relationships that support retention, responsiveness, and collaboration.
• Actively participate in ongoing periodic implementation meetings and professionally communicate estimated time to completion, potential or known problems, questions, and other pertinent information.

Program Development & Support

• Assist in the development, rollout, and ongoing management of specialized programs (e.g., Variable Copay, health system network/programs, optimized procurement strategies) and related provider communications.
• Support Liviniti Health network strategy, RFP responses, and new client implementations by providing information and assisting with access, gaps, and disruption analyses.
• Contribute to network strategy and growth, supporting new program development, expansion opportunities, and continuous enhancement of the Health System pharmacy experience.

Cross-Functional Collaboration & Process

• Partner with Clinical, Operations, Account Management, and Network teams to align pharmacy setup, program requirements, and issue resolution across the client lifecycle.
• Develop and maintain standard operating procedures, workflows, and job aids for pharmacy participation, communications, and program administration.
• Identify and implement process improvements that increase efficiency, consistency, and scalability across a growing pharmacy network.
• Support internal training and enablement by documenting processes and equipping cross-functional teams on pharmacy programs and procedures.

Reporting, Performance & Ticketing

• Responsible for ongoing pharmacy-specific reporting and updates, translating data into actionable insights on participation, performance, and program impact.
• Track and assist with all department ticket queues related to Health System owned/affiliated pharmacies and requests coming in from other departments.
• Monitor and report out performance service levels and guarantee items, proactively flagging risks and driving corrective action to meet commitments.

Compliance

• Ensure compliance with applicable regulatory and contractual requirements.
• Abide by all obligations under HIPAA related to Protected Health Information (PHI).
• If a HIPAA violation is discovered, whether individually or by another, report the violation to the Compliance Officer and/or Human Resources.
• Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company.
• Flexibility to understand, appreciate, and embrace that this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice., This position provides leadership and oversight for the department, including the supervision of managers and directors. The role is responsible for setting clear expectations, providing guidance and support, developing leaders, monitoring performance, and holding team members accountable for their responsibilities and results.

• Active pharmacist licensure.
• Project management and organizational rigor.
• Technical capacity.
• Problem solving/analysis.
• Development.
• Strong communicator, written and spoken.
• Self-learner.
• Cross-functional collaborator.
• Program and process development and oversight, * Doctor of Pharmacy (PharmD)
• 2 years relevant PBM experience
• Hospital health system experience
• Minimum of seven years of progressive experience in pharmacy network operations, PBM operations, managed care, healthcare compliance, regulatory affairs, audit management, or a related area.
• 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.

Preferred Education And Experience

• Bachelor’s degree in related field
• 2 years’ experience in a health care related field
• 2 years’ experience in business analysis
• Advanced degree, such as MBA, MHA, PharmD, JD, or related graduate degree preferred.
• Healthcare compliance, pharmacy technician, or related professional certification preferred.
• PBM, health plan, managed care, pharmacy network, or regulator-facing experience strongly preferred.
• Prior leadership experience building or improving compliance programs, audit processes, tracking tools, or governance frameworks preferred.

Pulled from the full job description

• On-the-job training
• Health insurance
• Retirement plan
• Paid time off
• Vision insurance
• Dental insurance
• Life insurance, * Some flexibility in hours is allowed, but the employee must be available during the “core” work hours of 8:00 AM to 5:00 PM CT. We cover clients from the West to the East Coast; work times must be adjusted to cover meetings in all time zones. Ability to work extended hours, weekends, and holidays in accordance with industry demands.

What We Have to Offer

Our benefits package is designed to keep our employees happy and healthy - physically, mentally, and financially.

• 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..