Senior Director, Pharmacy and PBM Operations

Thank you for considering Progyny!

The Pharmacy and PBM Operations Leader will oversee and manage Progyny’s pharmacy benefit management (PBM) program, driving operational excellence at both tactical and strategic levels. This role is responsible for leading end-to-end PBM and pharmacy-related operational projects, ensuring seamless integration of new programs and services, and serving as a strategic partner to leadership. The ideal candidate will possess deep industry expertise, strong leadership capabilities, and a visionary mindset to drive innovation and continuous improvement in a dynamic, high-growth environment.

What you'll do...

• Oversee and manage key PBM/pharmacy programs, providing operational leadership at both tactical and strategic levels.

• Develop, support, and execute end-to-end lifecycle of PBM/pharmacy-related operational projects and deliverables.

• Serve as the primary contact for PBM/pharmacy trading partners.

• Implement and enhance operational processes to improve efficiency, accuracy, and customer satisfaction.

• Collaborate with cross-functional teams for seamless integration of new programs and services.

• Monitor and analyze key performance indicators to identify areas for improvement and optimization.

• Act as a thought partner, sounding board, and strategic advisor to Progyny leadership and cross-functional partners.

• Provide analysis, recommendations, and options regarding high-impact decisions.

• Support the rebate management process from both trading partner and employer client perspectives.

About you...

• 12+ years of extensive experience in PBM operations, including interaction with self-funded and employer-sponsored health plan benefits.

• Doctor of Pharmacy preferred.

• Knowledge of accreditation standards (URAC, ACHC) is a plus.

• Comprehensive knowledge of PBM/pharmacy/healthcare industry, PBM operations, third party administrators, benefit setup (ASO and fully-insured), pharmacy claims, and managed care.

• Strong understanding of PBM processes: claims adjudication, network development, pricing, analytics/reporting, rebates, clinical aspects, trade, contracting, systems, and account management.

• Experience negotiating contracts with PBMs and pharmacies.

• Visionary mindset with the ability to anticipate and navigate emerging changes in the healthcare landscape and identify innovative solutions to complex challenges.

• Exceptional communication skills to convey complex PBM/pharmacy concepts to diverse stakeholders, fostering clear understanding and driving organizational success.

• Proven change agent with the ability to initiate and lead initiatives, motivate teams, and foster a culture of adaptability, high performance, accountability, excellence, and continuous improvement.

• High proficiency in project management methodologies for effective planning, execution, and monitoring of key initiatives, ensuring timely delivery of results.

• Strong analytical and problem-solving skills with attention to detail for addressing complex operational challenges.

• Ability to manage expectations and facilitate understanding at all organizational levels, both internally and externally.

• Capacity to lead, oversee, prioritize, and handle multiple projects and clients with dynamic and shifting timelines, utilizing proven project management processes.

• Demonstrated success in driving operational excellence and executing process improvements in a high-growth, fast-paced, entrepreneurial business setting, with a focus on measuring results and achieving targeted outcomes.

Progyny (Nasdaq: PGNY) is a global leader in women’s health and family building solutions, trusted by the nation’s leading employers, health plans and benefit purchasers. We envision a world where everyone can realize dreams of family and ideal health. Our outcomes prove that comprehensive, inclusive and intentionally designed solutions simultaneously benefit employers, patients and physicians.  

Our benefits solution empowers patients with concierge support, coaching, education, and digital tools; provides access to a premier network of fertility and women's health specialists who use the latest science and technologies; drives <