Pbm Implementation Jobs in Georgia (NOW HIRING)

Rx Valet is seeking an experienced, results-oriented PBM Operations Manager to lead our Shield PBM operations and client service teams. This is a senior leadership role responsible for overseeing Account Management, Client Services, Customer Service, and operational execution within our PBM division.

The ideal candidate is a proven leader with experience in pharmacy benefits management, healthcare administration, health plans, TPAs, or pharmacy operations. This individual must possess exceptional leadership skills, operational discipline, and a passion for delivering outstanding client and member experiences.

This position requires a hands-on leader who can drive accountability, develop high-performing teams, improve operational efficiency, and ensure exceptional service delivery while supporting the continued growth of the organization.

Key Responsibilities

Leadership & Team Development

• Lead and develop a team of Account Managers, Account Coordinators, Customer Service Representatives, and support staff.
• Create a culture of accountability, professionalism, collaboration, and continuous improvement.
• Conduct regular coaching, performance reviews, and career development planning.
• Establish measurable goals and performance expectations for all team members.
• Recruit, onboard, and retain top talent.
  

PBM Operations Management

• Oversee day-to-day Shield PBM operations, ensuring service levels and client expectations are consistently met.
• Monitor operational metrics including:
• • Claims processing timeliness
  • Client satisfaction
  • Call center performance
  • Service request resolution
  • Refill turnaround times
  • Prior authorization support
  • Implementation activities
• Identify operational bottlenecks and implement process improvements.
• Develop and maintain standard operating procedures (SOPs).

Client & Account Management Oversight

• Ensure Account Management teams provide exceptional service to employer groups, brokers, TPAs, and consultants.
• Participate in key client meetings and strategic reviews.
• Assist with client retention efforts and service recovery when necessary.
• Partner with sales and implementation teams to ensure smooth client onboarding.
  

Strategic Leadership

• Work closely with executive leadership to develop and execute departmental goals.
• Utilize data and reporting to identify trends, risks, and opportunities.
• Develop operational strategies that improve service quality and profitability.
• Support organizational growth initiatives and new product implementations.
  

Cross-Functional Collaboration

• Partner with:
• • Rx Valet Operations
  • Advanced Pharmacy
  • DMP Team
  • Finance
  • IT
  • Compliance
• Ensure seamless coordination between departments to deliver exceptional client and member experiences.

Qualifications

Required

• Bachelor's Degree in Business, Healthcare Administration, Pharmacy, or related field.
• 5+ years of management leadership experience in:
• • Pharmacy Benefit Management (PBM)
  • Health Insurance
  • TPA Operations
  • Pharmacy Operations
  • Healthcare Administration
• 5+ years managing multiple teams and supervisors.
• Strong understanding of PBM operations and client service models.
• Experience managing performance metrics and operational KPIs.
• Demonstrated success leading organizational change and process improvement initiatives.
• Excellent communication and presentation skills.
• Strong analytical and problem-solving abilities.
• Proficiency with Microsoft Office and operational reporting systems.
  

Preferred

• Experience working with self-funded employer groups.
• Knowledge of pharmacy claims processing, specialty pharmacy, formulary management, and clinical programs.
• Experience with CRM, ticketing, and PBM administration platforms.

Key Leadership Competencies

The successful candidate will demonstrate:

• Ownership Mentality
• Strong Decision-Making Skills
• High Accountability
• Team Building and Coaching
• Operational Excellence
• Client-Centric Leadership
• Continuous Improvement Mindset
• Ability to Manage Through Growth and Change

Performance Metrics

Success in this role will be measured by:

• Client retention rates
• Client satisfaction scores
• Member satisfaction scores
• Call center service levels
• Claims processing accuracy and timeliness
• Team engagement and retention
• Department productivity metrics
• Implementation success rates
• Achievement of departmental financial and operational goals

Compensation & Benefits

• Competitive Salary (based on experience)
• Performance Bonus Opportunity
• Health Benefits
• Paid Time Off
• Professional Development Opportunities
• Leadership Growth Path
  

Ideal Candidate Background

Candidates from the following organizations would be particularly attractive:

• Mid-market PBMs
• Health Plans
• TPAs
• Specialty Pharmacies
• Pharmacy Consulting Firms
• Benefits Administration Companies
• Healthcare Service Organizations
  

Salary range of $65,000–$85,000 plus a 15–20% annual bonus opportunity.