Pharmacy Benefits Senior Manager

Location: Remote USA

Salary: $110,500–$173,000 per year

Company

hirify.global is a healthcare company founded in 2017 that combines clinical services, data, and AI to improve the health and well-being of older Americans.

What you will do

• Own the PBM relationship, procurement, RFPs, contract negotiations, guarantees, audits, and market checks.
• Manage pharmacy trend, PMPM/PMPY forecasting, claims analytics, savings initiatives, and reconciliation of projected versus realized savings.
• Lead PBM implementations, formulary changes, plan-design rollouts, audits, milestones, dependencies, and go-live readiness.
• Oversee formulary, utilization management, specialty-drug, high-cost-claimant, stop-loss, and preferred-product strategies.
• Coordinate Finance, Legal, Compliance, Clinical, Data, vendors, and client HR stakeholders.
• Support ERISA fiduciary processes, benchmarking, documentation, member communications, appeals, and coverage escalations.

Requirements

• 5–8+ years of experience in pharmacy benefits, PBM operations or account management, payer or managed-care pharmacy, or benefits consulting.
• Demonstrated ownership of PBM contracting and pharmacy trend outcomes.
• Deep knowledge of PBM economics, pricing guarantees, rebates, spread, formulary and utilization-management levers, and specialty-drug management.
• Strong claims analytics, financial modeling, and BI capabilities, including the ability to validate PBM reporting.
• Experience managing complex, multi-stakeholder projects and knowledge of ERISA fiduciary obligations and CAA/RxDC transparency requirements.
• Outstanding communication and clear, risk-aware status reporting for executives, clinicians, clients, and benefits committees.

Nice to have

• PharmD or RPh.
• Master’s degree in business, public health, or a related field, or an actuarial or financial background.
• Benefits consultancy, PBM, payer, client-facing account-management, or self-insured plan-sponsor experience.
• Experience using LLMs to build prompts and lightweight tools for analysis and reporting.

Culture & Benefits

• Remote work arrangement for the USA.
• Employer-sponsored health, dental, and vision plans with low or no premium.
• Generous paid time off and parental leave.
• $100 monthly mobile or internet stipend.
• Stock options for all employees, bonus eligibility for roles below Director, and a 401(k) program.