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Summary of Duties

• Position is responsible for overseeing the technological infrastructure and systems that support our PBM operations
• Primary focus will be on managing and optimizing the IT functions within our PBM environment, ensuring seamless integration, data management, and efficient workflows
• This individual will possess strong pharmacy benefits industry knowledge and interpersonal skills to build credibility with, and foster professional relationships with senior executives in Human Resources, Finance, and Others as appropriate
• The ideal candidate should possess extensive experience in the PBM industry, a strong understanding of various file formats, automated transfer protocols, and exceptional data management capabilities

Supervisor: Member of the Leadership Team

Collaborates With: Business and unit leaders across MFO portfolio, PBM leadership team, innovation team, account management resources, implementation team, marketing, channel partners, and other TPAs, as appropriate

Key Responsibilities

Responsibilities to include (but not be limited to) the following:

• PBM System Management:
  • Oversee the design, implementation, and maintenance of IT systems and infrastructure supporting PBM operations.
  • Ensure that all systems are optimized for efficiency, reliability, and security.
  • Collaborate with internal teams to identify and implement process improvements through technology enhancements.
  • Stay updated on industry trends and advancements in PBM technology to ensure the organization remains competitive and innovative.
• File Format Management:
  • Possess a deep understanding of various file formats commonly used in the PBM industry (e.g., NCPDP, XML, EDI).
  • Develop and maintain expertise in interpreting, validating, and transforming data between different file formats.
  • Collaborate with business stakeholders and external partners to ensure seamless integration and data exchange.
  • Design and administer control total testing procedures for inbound and outbound files.
• Automated Transfer Protocols:
  • Design and implement automated transfer protocols to enable secure and efficient data exchange between internal and external systems.
  • Evaluate, select, and configure appropriate technologies and tools for file transfers (e.g., SFTP, FTPS, AS2).
  • Develop and enforce data transmission standards to ensure data integrity, security, and compliance.
• Data Management:
  • Oversee Electronic Data Warehouse and associated policies and procedures.
  • Oversee the management of large datasets, ensuring data accuracy, availability, and accessibility.
  • Implement robust data governance practices to maintain data integrity and privacy.
  • Collaborate with cross-functional teams to develop data analytics capabilities and provide meaningful insights for business decision-making.
• Team Leadership and Collaboration:
  • Lead and mentor the IT team, fostering a collaborative and high-performing culture.
  • Collaborate with stakeholders across the organization to understand IT needs, align technology strategies, and prioritize projects.
  • Coordinate with vendors, consultants, and external partners to leverage expertise and resources as needed.

Capabilities:

• Strong knowledge of various file formats used in the PBM space (e.g., NCPDP, XML, EDI) and their integration into enterprise systems.
• Proficiency in designing and implementing automated transfer protocols (e.g., SFTP, FTPS, AS2) for secure and efficient data exchange.
• Experience managing large datasets, ensuring data integrity, and implementing data governance practices.
• Familiarity with pharmacy operations and understanding of the healthcare industry's regulatory landscape.
• Exceptional leadership skills with a demonstrated ability to motivate and guide teams toward achieving strategic goals.
• Excellent problem-solving and decision-making abilities, with a strong focus on innovation and continuous improvement.
• Effective communication skills, both verbal and written, with the ability to convey complex technical concepts to non-technical stakeholders.

Status:

• Position will be virtual (work from home) in an office-like environment

Education:

• Bachelor's degree in Computer Science, Information Technology, or a related field. Master's degree preferred.

• Proven experience (5+ years) in a leadership role within the PBM industry, with a focus on IT infrastructure and systems.

Certifications and/or Licensure:

• Professional certification (PMP, CAPM, or like designation) a plus, but not required

Physical Demands and Working Conditions:

• May require prolonged sitting, some bending, stooping and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, printer, telephone, calculator and other office equipment. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports. Some lifting of material up to 10-15 pounds may be required. Position is work from home, but in an office environment. Work may be stressful at times and contact may involve dealing with angry or difficult people. Staff must remain flexible and available to provide staffing assistance for any/all disaster or emergency situations.