Pharmacy Solutions Manager - REMOTE

Job ID: Remote

About the Role

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 teams, 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 specialized support to manage and grow the network with accuracy, consistency, and excellence.

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.
  • 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).
  • Report any HIPAA violations to the Compliance Officer and/or Human Resources.
  • Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company.
• Flexibility to adapt to changing duties, responsibilities, or activities as needed.

Requirements

• Active pharmacist licensure.
• Doctor of Pharmacy (PharmD).
• 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.
• Hospital health system experience.
• 2 years relevant PBM experience.

Preferred Qualifications

• Bachelor’s degree in a related field.
• 2 years’ experience in a healthcare-related field.
• 2 years’ experience in business analysis.
• Advanced degree, such as MBA, MHA, PharmD, JD, or related graduate degree.
• Healthcare compliance, pharmacy technician, or related professional certification.
• 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.

Skills

• Project management and organizational rigor.
• Technical capacity.
• Problem solving/analysis.
• Development and oversight of programs and processes.
• Strong written and verbal communication.
• Self-learner.
• Cross-functional collaborator.

Supervisory Responsibility

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.

Schedule

• This is a full-time, salaried position.
• Core work hours are 8:00 AM to 5:00 PM CT, with flexibility required to cover meetings across all U.S. time zones.
• Ability to work extended hours, weekends, and holidays in accordance with industry demands.

Travel

Expect 30% travel for this position.

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).