Director of Pharmacy Benefit Operations

Description

ABOUT TRUDATARX

TruDataRx, Inc. uses objective clinical data to help clients improve the clinical efficacy and reduce the costs of pharmacy benefits for its members. We are independent from all players in the pharmaceutical manufacturing and distribution industries, enabling us to best serve our clients. We value the following characteristics in our team members:

• Outward Mindset – foundation of our culture, which influences the right behaviors, that leads to results
• Entrepreneurial – the ability to get things done with resources you don’t control
• Humility – deep comfort in knowing when you don’t know and asking questions
• Collaboration – we always give benefit of doubt that each person has something to contribute

POSITION SUMMARY:

The Director of Pharmacy Benefit Operations leads and optimizes the core clinical pharmacy functions at TruDataRX, including custom formulary management, client support, member services, prior authorizations and appeals. This is a hands-on leadership role responsible for building and operationalizing the pharmacy operations function, including standing up new systems, workflows, and teams to support scalable, high-impact service delivery.

ESSENTIAL FUNCTIONS

• Build the pharmacy operations department from the ground up, actively engaging in day-to-day execution while designing for long-term scalability.
• Lead day-to-day clinical pharmacy operations across TruDataRx’s suite of services including prior authorizations, member service, and custom formulary management. 
• Partner with clinical, IT, data, and account teams to align operational efforts with strategic goals. 
• Define and implement scalable workflows, standard operating procedures (SOPs), and performance metrics to enhance team efficiency. Identify continuous improvement initiatives and process optimization across formulary management, documentation and client communications, driving efficiencies in overall service delivery.
• Serve as a liaison between internal stakeholders and external partners, including PBMs and third-party vendors. Manage vendor relationships with optimized workflows across functions such as rebate aggregators, specialty pharmacies, and claims processors.
• Facilitate the translation of P&T Committee decisions into actionable client-specific workflows, organizing clinical staff and coordinating task assignments.
• Provide guidance to client account teams on market events, legislative changes, and P&T Committee outcomes.
• Maintain strong client relationships with a deep understanding of their individual business and culture, proactively addressing trends or service gaps by monitoring KPIs and client/member satisfaction metrics. 
• Lead client meetings, vendor reviews and performance assessments, ensuring deliverables are accurate, data- driven and aligned with TruDataRX’s core principles. 
• Collaborate with IT/data teams to streamline system integration, automation, and reporting tools. Monitor system performance, troubleshoot issues, and advocate for technology upgrades to support operational goals.
• Develop audits, corrective actions, and oversee reporting for service levels and regulatory submissions to ensure data accuracy and compliance. Ensure operational adherence to regulatory and accreditation requirements (e.g., CMS,SOC, HIPAA)

Requirements

REQUIREMENTS

• Doctor of Pharmacy or other advanced degree relevant to healthcare/pharmacy benefit operations
• 7+ years in healthcare operations (PBM, formulary management or managed care preferred)
• Demonstrated ability to lead cross-functional operational teams in a data-driven and fast-paced environment
• Proven leadership in scaling workflows, managing timelines, cross-functional teams and quality control in fast-paced healthcare environments, preferably pharmacy benefit management. 

Company Standard Requirements:

• Ability to work well with others in a collaborative environment
• Ability to get things done with resources you don’t control
• Willingness to admit you don’t know and ask for help
• Exhibit constant curiosity and a drive to problem solve
• Exhibit desire to learn and grow on a continuous basis