Director of Technical Operations

Job Summary

A company is looking for a Director, PBM Technical Operations.

Key Responsibilities

• Oversee regulatory interpretation and operational expertise for Government Programs
• Ensure compliance with Medicare, Medicaid, and Exchange claims adjudication requirements
• Support budget and staffing plans while monitoring program regulations and business processes

Required Qualifications

• Bachelor's Degree required
• 5 years of experience in a PBM, health plan, or managed care environment
• Knowledge of project management and claims adjudication
• Proven track record of process improvement and regulatory compliance
• Experience in leading projects and teams