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.

• 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 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.

• 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.

• 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.

• 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.

• 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.

• 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…