Pharmacy Program Manager

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.

We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.

The Pharmacy Program Manager leads the development, implementation, and optimization of pharmacy programs and strategic initiatives across Medica's Commercial, Medicare, Medicaid, and Individual & Family Business (IFB) lines of business. This role translates enterprise pharmacy strategy into actionable programs that improve affordability, competitiveness, operational performance, and member experience. The position serves as a key liaison across Clinical Pharmacy, Actuarial, Finance, Operations, Product, Sales, Account Management, Government Programs, and external pharmacy partners. Through strong program management, stakeholder engagement, and strategic leadership, this role drives initiatives from concept through implementation while ensuring alignment with organizational priorities and business objectives. Performs other duties as assigned.

Key Accountabilities

Lead Pharmacy Strategy, Programs & Initiatives

• Lead pharmacy programs and strategic initiatives across Commercial, Medicare, Medicaid, and IFB.
• Translate pharmacy strategy into market-ready solutions that support affordability, growth, and member experience goals.
• Develop business cases, implementation plans, and recommendations for leadership.
• Support governance, prioritization, and execution of pharmacy initiatives.

Support Product, Pricing & Market Strategy

• Support formulary, network, benefit design, pricing, and affordability strategies.
• Lead pharmacy contributions to Medicare bids, ACA filings, Medicaid procurements, and Commercial product and renewal cycles.
• Monitor market trends, competitor strategies, and emerging pharmacy solutions.
• Identify opportunities to enhance Medica's pharmacy value proposition and market competitiveness.

Lead Program Planning, Execution & Delivery

• Define project scope, timelines, deliverables, success metrics, and resource requirements.
• Lead complex cross-functional initiatives from planning through implementation.
• Manage risks, dependencies, issue resolution, and stakeholder communications.
• Ensure initiatives are delivered on time and aligned with business objectives.

Partner with Stakeholders & Pharmacy Vendors

• Serve as the primary relationship manager for key pharmacy vendors and strategic partners.
• Collaborate across Clinical Pharmacy, Finance, Actuarial, Operations, Product, Sales, and Account Management.
• Influence partner strategies, service models, and solution design.
• Communicate program impacts, recommendations, risks, and opportunities to leadership.

Drive Performance & Continuous Improvement

• Monitor financial, operational, utilization, and affordability performance.
• Analyze program outcomes and identify opportunities for improvement.
• Develop recommendations based on data analysis, market intelligence, and stakeholder feedback.
• Lead continuous improvement efforts that enhance program effectiveness and member outcomes.

People & Resource Leadership

• Lead and develop employees and assigned project resources.
• Support prioritization, workload management, and resource planning activities.
• Provide coaching, direction, and feedback to support team success.
• Foster a collaborative, accountable, and high-performing work environment.

Required Qualifications

• Bachelor's degree in Pharmacy, Healthcare Administration, Business Administration, Public Health, Finance, Actuarial Science, or a related field; equivalent combination of education and experience considered.
• 8+ years of progressive experience in managed care pharmacy, health insurance, pharmacy benefit management (PBM), healthcare consulting, or related healthcare program management roles.
• 5+ years of experience leading complex, cross-functional strategic initiatives from concept through implementation.
• Experience supporting pharmacy-related product development, pricing strategies, bid processes, regulatory filings, or market competitiveness initiatives.
• Experience managing project scope, timelines, budgets, risks, dependencies, and stakeholder communications across multiple simultaneous initiatives.

This position is an Office role, which requires an employee to work onsite at our Minnetonka, MN office, on average, 3 days per week.

The full salary grade for this position is $113,400 - $194,400. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $113,400 - $170,100. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.