Manager, PBM Tech Operations



Manager, PBM Tech Operations Jersey City, New Jersey

Title: Tech Operations Manager

Job Type: Permanent

Primary Location: Jersey City, New Jersey

The Challenge:

Vignetic is looking for a Manager of PBM Tech Operations who will oversee technical operations and new implementations. Be responsible for data integrity, accumulators, eligibility, other PBM Tech Operations and manage concierge tickets / member escalations.

Roles & Responsibilities:

  • Manage and maintain the day-to-day operational activities like Eligibility, Accumulator, DMR Reimbursements, Claim Rejections etc.
  • Hands-on development experience with ability to analyze, understand, guide, and resolve technical problems.
  • Support and manage the ongoing tickets and member escalations.
  • Manage and maintain the daily jobs, failures, and resolutions.
  • Report the health check of Benefit plans.
  • Work with cross functional team members on maintaining existing plans and new implementations.
  • Develop, implement, and maintain Process Improvement and Quality Improvement plans.
  • Focus on continued process improvement and efficiencies, stay up to date with current PBM strategies and trends in the marketplace.

Essential Skills & Requirements:

  • Minimum of 7 years of PBM experience, preferable in an IT environment Knowledge of claim adjudication processes¬†and Tech Operations.
  • 5 Years of development experience.
  • Experience in managing team and consultants (Onsite & Offshore).

Preferred Qualifications:

  • CS background or affinities
  • Experience in a high growth technology company

Tagged as: Manager, PBM Tech Operations