Vice President, Pharmacy

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We're constantly reimagining what's possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.

At Machinify, we're constantly reimagining what's possible in our industry - creating disruptively simple, powerfully clear ways to maximize our clients' financial outcomes today and drive down healthcare costs tomorrow. As part of the Pharmacy team, you will lead and scale our pharmacy operations organization. This is a senior leadership role for an operator who is equally comfortable in a client-facing strategy conversation and in the production system reviewing a claim line by line.

• Lead a pharmacy operations organization with direct reports ranging from Senior Manager through Director level, and overall accountability for the broader team beneath them.
• Build and sustain a culture that holds team members to demanding performance standards while making Machinify a place people want to work. These are complementary objectives.
• Coach and train managers to recognize underperformance early and conduct clear, constructive, well-documented performance conversations.
• Recognize and publicize excellent work; create visible standards for what great performance looks like.
• Champion and lead employee engagement and cultural initiatives; remain visible and accessible to employees at every level of the organization.
• Partner closely with People Operations on hiring, workforce planning, policy development, and consistent enforcement of expectations.

• Continuously identify efficiency opportunities across pharmacy operations workflows and eliminate steps that do not create value.
• Re-engineer unnecessarily manual processes, selecting the most effective solution path for each problem:
  • Applying an existing internal or vendor tool that directly solves the problem
  • Repurposing or extending an existing tool
  • Partnering with Software Engineering to scope and prioritize a custom solution
• Identify, codify, and teach superior operating techniques - from call handling and verbal persuasiveness to efficient system navigation and parallel task execution.
• Set, communicate, and manage to clear performance expectations and productivity targets across recovery outcomes, case throughput, and outbound contact activity.
• Use operational data to diagnose root causes rather than symptoms, and to prioritize where improvement effort is spent.

• Independently own strategic initiatives end to end: build the plan, assign responsibilities, sequence the work, and drive cross-functional collaboration to implement change quickly and durably.
• Serve as a communications leader internally, including regular presentation at All Hands and other company-wide forums.
• Interface directly with clients and with the Executive Leadership Team; act as a primary presenter on external client and sales calls as needed.
• Bring the operational point of view into company-level strategy, technology roadmap, and client commitment discussions.

• Progressive leadership experience in pharmacy operations, pharmacy benefit management, healthcare claims, payment integrity, or a closely related operational domain, including experience managing managers.
• Demonstrated track record of improving operational performance - measurable gains in productivity, quality, recovery, or cost - through process redesign rather than headcount alone.
• Working fluency with operational systems and data: able to learn a new platform quickly, work in it directly, and identify errors and inefficiencies without relying solely on delegated answers.
• Experience partnering with technology teams to define requirements and deliver tooling or automation improvements.
• Executive-level written and verbal communication skills, with experience presenting to senior leadership and to external clients.
• Experience building and executing consistent, well-documented performance management processes.

• Direct experience in pharmacy claims review, prescription drug recovery, or PBM audit environments.
• Familiarity with the regulatory environment, reimbursement mechanics, claims auditing, coordination of benefits (COB), and compensation structures relevant to healthcare claims or pharmacy benefits.
• Demonstrated performance in accounts receivable management (ARM), over payment recovery, or revenue cycle management.
• Experience scaling an operations team through a period of…