PBM管理副总裁
Vice President, PBM Management
**_打造国内最具创新性的Medicare Advantage计划背后的药房策略。_**
在Clover Health，我们致力于为美国老年人提供高质量、负担得起且易于理解的医疗保健计划。我们优先考虑预防性护理，同时通过Clover Assistant利用数据和技术，使医生对每位会员有更全面的了解，从而以更低的成本实现更好的结果。
药房是Medicare Advantage中最重要的杠杆之一。它影响着可负担性、临床结果、会员体验和长期计划表现。
我们正在寻找一位高管来负责该策略。
作为PBM管理副总裁，您将领导Clover的Medicare Advantage计划的药房策略职能。您将负责我们的PBM合作、PBM合同义务、处方集策略、药房经济以及整体PBM财务表现。您将与高管团队紧密合作，确保药房和PBM管理成为竞争优势，而不仅仅是一个成本中心。
直接向Medicare Advantage业务的CEO汇报，您将参与制定企业战略，同时领导PBM策略、合同执行和财务优化。
**作为PBM管理副总裁，您将：**
- 负责整个健康计划中的Medicare Advantage药房策略。
- 领导与PBM的关系，推动合同执行、服务水平、成本管理和严格遵守合同义务。
- 制定处方集策略，平衡临床质量、会员体验和财务表现。
- 确保所有供应商协议和CMS要求下的PBM合同合规性和监督。
- 负责宏观药房支出管理的识别。
- 建立并领导一支药房团队，协助管理关键的PBM和供应商关系。
- 与财务部门合作进行预测、回扣策略和药房经济分析。
- 与临床护理服务、网络、法律和产品负责人合作，最大化PBM表现和财务成果。
- 通过确保PBM执行、合同履行和处方集决策支持企业Part D Stars计划，同时与专门的药房Stars & Cares计划团队密切合作。
- 就新兴药房法规、市场动态和战略机会提供建议。
- 持续识别机会
查看英文原文
**_Build the pharmacy strategy behind one of the country's most innovative Medicare Advantage plans._**
At Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America's seniors. We prioritize preventive care while leveraging data and technology through the Clover Assistant, giving physicians a more complete picture of every member and helping deliver better outcomes at lower cost.
Pharmacy is one of the most important levers in Medicare Advantage. It influences affordability, clinical outcomes, member experience, and long-term plan performance.
We're looking for an executive to own that strategy.
As Vice President of PBM Management, you'll lead the pharmacy strategy function for Clover's Medicare Advantage plan. You'll own our PBM partnership, PBM contractual obligations, formulary strategy, pharmacy economics, and overall PBM financial performance. You'll partner closely with executive leadership to ensure pharmacy and PBM management are a competitive advantage—not simply a cost center.
Reporting directly to the CEO of the Medicare Advantage business, you'll help shape enterprise strategy while leading PBM strategy, contract enforcement, and financial optimization.
**As Vice President, PBM Management, you will:**
- Own the Medicare Advantage pharmacy strategy across the health plan.
- Lead Clover's relationship with its PBM, driving contract performance, service levels, cost management, and strict adherence to contractual obligations.
- Develop formulary strategy balancing clinical quality, member experience, and financial performance.
- Ensure PBM contractual compliance and oversight across all vendor agreements and CMS requirements.
- Responsible for identification of macro pharmacy spend management
- Build and lead a team of pharmacy associates to assist with managing critical PBM and vendor relationships.
- Partner with Finance on forecasting, rebate strategy, and pharmacy economics.
- Partner with Clinical Care Services, Network, Legal, and Product leaders to maximize PBM performance and financial outcomes.
- Support enterprise Part D Stars initiatives by ensuring PBM execution, contractual fulfillment, and formulary decisions enable program success while partnering closely with the dedicated Pharmacy Stars & Cares Initiatives team.
- Provide executive recommendations on emerging pharmacy regulations, market dynamics, and strategic opportunities.
- Continuously identify opportunities to improve quality, affordability, and overall financial performance across PBM contracts.
**Success in this role looks like:**
- **First 90 days**
- Build trusted relationships with executive leadership and key PBM partners.
- Assess PBM performance, contract compliance, formulary strategy, and financial optimization opportunities.
- Develop a multi-year pharmacy strategy aligned to Clover's Medicare Advantage objectives.
**First 6 months**
- Implement measurable improvements in PBM governance and performance management.
- Deliver strategic recommendations on formulary optimization and pharmacy economics.
- Establish operating rhythms across internal pharmacy strategy, finance, legal, and care management teams.
**Long term**
- Pharmacy becomes a strategic competitive advantage for Clover.
- Improved pharmacy affordability while maintaining or improving quality.
- Best-in-class PBM oversight, contract performance, and financial return.
- High-performing pharmacy organization that scales with the business.
**You should get in touch if:**
- You've led pharmacy strategy inside a Medicare Advantage plan or similarly complex payer.
- You have deep experience managing PBMs and pharmacy vendors.
- You understand formulary management, PBM contract enforcement, CMS regulations, and pharmacy economics.
- You can balance clinical quality, member experience, and financial performance.
- You're equally comfortable influencing executives and driving contract negotiation and enforcement details.
- You enjoy building organizations and leading through influence across highly matrixed teams.
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**Benefits Overview**:
- **Financial Well-Being**: Our commitment to attracting and retaining top talent begins with a competitive base salary and equity opportunities. Additionally, we offer a performance-based bonus program, 401k matching, and regular compensation reviews to recognize and reward exceptional contributions.
- **Physical Well-Being**: We prioritize the health and well-being of our employees and their families by providing comprehensive medical, dental, and vision coverage. Your health matters to us, and we invest in ensuring you have access to quality healthcare.
- **Mental Well-Being**: We understand the importance of mental health in fostering productivity and maintaining work-life balance. To support this, we offer initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy. Additionally, we embrace a remote-first culture that supports collaboration and flexibility, allowing our team members to thrive from any location.
- **Professional Development**: Developing internal talent is a priority for Clover. We offer learning programs, mentorship, professional development funding, and regular performance feedback and reviews.
_Additional Perks:_
- Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities
- Reimbursement for office setup expenses
- Monthly cell phone & internet stipend
- Remote-first culture, enabling collaboration with global teams
- Paid parental leave for all new parents
- And much more!
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**About Clover:** We are reinventing health insurance by combining the power of data with human empathy to keep our members healthier. We believe the healthcare system is broken, so we've created custom software and analytics to empower our clinical staff to intervene and provide personalized care to the people who need it most.
We always put our members first, and our success as a team is measured by the quality of life of the people we serve. Those who work at Clover are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.
From Clover’s inception, Diversity & Inclusion have always been key to our success. We are an Equal Opportunity Employer and our employees are people with different strengths, experiences, perspectives, opinions, and backgrounds, who share a passion for improving people's lives. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion and many other parts of one’s identity. All of our employee’s points of view are key to our success, and inclusion is everyone's responsibility.
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#LI-REMOTE
_Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. We are an_ [_E-Verify_](https://e-verify.uscis.gov/esp/media/resourcesContents/E-Verify_Participation_Poster.pdf) _company._
Final pay is based on several factors including but not limited to internal equity, market data, and the applicant’s education, work experience, certifications, etc.
A reasonable estimate of the base salary range for this role is:
$278,000—$320,000 USD