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Manager, Pharmacy Strategy & Operations

The Manager, Pharmacy Strategy & Operations (Pharmacy S&O), is the single-threaded owner of customer outcomes across a portfolio of Alchemy's in-house pharmacy partners. This is not a traditional Customer Success role, and more in line with a GM role, or what we describe internally as the "CEO of the Account."

You are accountable for financial performance, operational execution, clinical program coordination, workforce influence, compliance readiness, and strategic growth at each site. You will identify issues before they escalate, orchestrate cross-functional support when needed, and ensure no client experiences a handoff or siloed service model.

Pharmacy S&O serves as the conductor of the account. Implementation, Compliance, Finance, Engineering may step forward during certain steps in the customer's lifecycle, but you remain accountable for the outcome. Success in this role requires pattern recognition, operational instinct, strong client influence, financial literacy, and the ability to coordinate without direct authority.

Key Responsibilities

Full Lifecycle Ownership

• Serve as the primary owner of client relationships from Day 1 post-signing through launch, ramp, and long-term growth.
• Ensure seamless coordination between Sales, Implementation, Compliance, and Operations.

Financial & Operational Performance

• Own account-level performance across revenue, capture rate, profitability, forecast adherence, and operational pacing.
• Identify and diagnose performance gaps (e.g., shortened operating days, unexplained pacing misses, inventory over-ordering, etc.) and implement the necessary solutions including rolling up your sleeves to do the work yourself.
• Partner with Finance to monitor trends, reconcile anomalies, and implement corrective actions.
• Influence clinic leadership when operational changes are required to meet financial targets.

Strategic Client Management & Leadership

• Anticipate commercial renegotiation risks and ongoing needs of your accounts while having an eye towards ensuring long term retention.
• Partner with Finance to communicate the monthly/quarterly/annual performance of the pharmacy and alignment with the clinic's overall financial goals
• Manage executive-level client escalations with clarity and composure.
• Translate complex data into polished, decision-ready outputs for clients.

Workforce & Staffing Influence

• Influence PIC, PRN, and technician staffing decisions in partnership with others.
• Participate in sourcing, hiring, compensation discussions, and onboarding coordination.
• Identify staffing risks early and drive proactive solutions to ensure long term retention of our pharmacy staff.

Compliance & 340B Advisory Coordination

• Stay ahead of 340B policy changes, manufacturer restrictions, rebate pilots, and audit risks.
• Coordinate with Compliance & Implementation to ensure audit readiness and policy hygiene.
• Translate regulatory developments into actionable guidance for clients.

Data & Systems Orchestration

• Understand and develop a mastery of all financial and operating metrics for your clients (at all times).
• Spot reporting gaps, data inconsistencies, or system issues (e.g., EMR downloads, NDC trend anomalies, 340B pricing changes).
• Ensure account-level metrics are complete, accurate, and actionable.

Vendor & Procurement Management

• Troubleshoot inventory or wholesaler discrepancies.
• Maintain financial and operational hygiene across vendor relationships.
• Manage transition of vendors as requested by the Client (e.g. switching to a new TPA)

Cross-Functional Orchestration

• Identify issues through pattern recognition, client signals, or performance data.
• Determine when to solve independently versus when to "swarm" with shared resources across the company.
• Maintain clear lines of accountability so work does not stall or fall through the cracks.

A Day in the Life

• Review account dashboards and immediately flag two sites pacing behind forecast. It's close to the end of the month so you don't have time for all the data/answers so you call 40 patients to have them pick up their refills.
• Call a clinic executive to influence adding operating hours to recover lost revenue.
• Coordinate with Finance to analyze unexpected NDC margin compression.
• Escalate a potential 340B manufacturer restriction issue and translate its impact into a client action plan.
• Work with Pharmacy Ops team on sourcing a PIC replacement and pressure-test staffing timing against forecast.
• Join an implementation call for a new launch while running the parallel playbook (P&Ps, workforce, eRx analysis).
• Draft a polished summary for a CFO explaining a commercial benchmarking analysis across competitors.
• End the day clarifying ownership on three open issues so nothing lingers overnight.

What Success Looks Like

• No ambiguity around ownership at your accounts.
• Financial performance meets or exceeds forecast.
• Clients view you as a strategic partner, not a vendor.
• Fewer heroics. Fewer fire drills. More anticipation.
• Cross-functional work moves quickly and efficiently in service of your clients, your client always feels like they have the entire Alchemy team behind their success.
• Customer satisfaction remains high, they want to stay with Alchemy forever :)

Minimum Experience

• 4–8+ years in operations, healthcare services, consulting, pharmacy operations, customer success, or relevant cross-functional ownership role.
• Demonstrated ability to manage complex client relationships with multiple stakeholders.
• Comfort owning financial outcomes (forecasting, margin drivers, performance diagnostics).
• Strong analytical instincts and ability to translate data into action.
• Proven ability to coordinate cross-functional teams without direct authority.
• Experience in 340B, pharmacy operations, retail or clinical pharmacist experience, public health, or regulated healthcare environments preferred but not required.

Salary and Benefits

We offer a competitive compensation package, including a base salary, equity award, and other benefits outlined below. This is a remote role and the base salary range for this role is USD $150,000 per year - USD $180,000 per year.

Our Benefits

• Remote-first culture
• 401(k) savings plan with a 4% company match
• Comprehensive medical, vision, and dental coverage through a select plan option
• Unlimited Paid Time Off ("PTO") and Discretionary Time Off ("DTO") with manager approval
• Participation in any company-wide bonus program based on individual and company performance

About Alchemy

Alchemy builds and operates in-house pharmacies for safety net clinics, with a focus on STD clinics, Ryan White Grantees, and FQHCs serving patients living with HIV and Hepatitis C. We provide the physical, clinical, and digital pharmacy infrastructure that enables clinics to reclaim control of their 340B programs, ensure access to essential medicines for their patients, and integrate wrap-around services that strengthen community health.

Alchemy is the fastest growing company building in-house pharmacies for safety-net clinics. We've raised $31M from Andreessen Horowitz, Magic Johnson, and The Banc of California, and we're scaling fast. Our team has deep clinical pharmacy, technology, and operations experience. Collectively, we have spent 18 years in Africa building the largest HIV access program in the world, and we have set up, operated and scaled pharmacies that have dispensed over 25M+ prescriptions to patients across all 50 states in the US. After setting up a clinic's in-house pharmacy, we design and implement clinical pharmacy programs and deploy technology products that leverage the pharmacy to expand patient reach, improve clinical outcomes, and increase the financial impact of their 340B program.

If you're a mission-driven Finance leader looking for a rare corner of U.S. healthcare where better patient outcomes and better financial results go hand in hand, this is your opportunity.

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