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Health Plans General Manager

Remote

We are a healthcare technology company that provides platforms and solutions to improve the management and access of cost-effective pharmacy benefits. Our technology helps enterprise and partnership clients simplify their businesses and helps consumers save on prescriptions.

As a leader in SaaS technology for healthcare, we offer innovative solutions with integrated intelligence on a single enterprise platform that connects the pharmacy ecosystem.  With our expertise and modern, modular platform, our partners use real-time data to transform their business performance and optimize their innovative models in the marketplace.

Position Overview:

The Health Plan General Manager is an executive role that combines operational leadership with a strong go-to-market and business development focus. This role will be responsible for overseeing health plan client operations while driving growth through direct engagement with health plans, PBM consultants, brokers, and other key influencers. The ideal candidate will be equally comfortable managing client performance and leading sales strategies to expand our footprint across the payer landscape.

Key Responsibilities:

Operational Leadership:

  • Serve as the executive sponsor for health plan clients, ensuring seamless onboarding, integration, and long-term success.
  • Oversee all aspects of health plan operations, including benefit design, claims administration, formulary strategy, and compliance.
  • Collaborate with internal teams to ensure delivery excellence, regulatory adherence, and member satisfaction.
  • Continuously improve processes and workflows to support scalable, high-quality service delivery.
  • Monitor and report on key client KPIs and performance metrics.
  • Lead the already in development Medicare Part-D and Medicaid services expansion

 

Go-to-Market & Sales Enablement:

  • Lead the sales and marketing teams to develop and execute a targeted go-to-market strategy focused on health plans.
  • Cultivate relationships with PBM consultants, brokers, and industry influencers
  • Leadership over RFP responses, client pitches, and product demonstrations tailored to health plan prospects.
  • Identify and develop strategic partnerships that align with our mission to enable next-generation PBM models.

 

Strategic Growth & Client Success:

  • Work closely with product and clinical teams to align offerings with evolving health plan needs and regulations.
  • Oversee account expansion and renewals by showcasing measurable value and performance outcomes.
  • Serve as the voice of the client internally, championing innovation and service excellence.

Qualifications:

  • 10+ years of experience in pharmacy benefit management, including senior-level roles in health plan operations and/or business development.
  • Proven success driving go-to-market initiatives and sales enablement, particularly with health plans and PBM consultants.
  • Deep understanding of pharmacy benefit structures, regulatory frameworks, and cost containment strategies.
  • Established relationships with PBM consultants, brokers, or payers strongly preferred.
  • Strong executive presence, communication, and negotiation skills.
  • Strategic thinker with operational rigor and a track record of delivering measurable outcomes.
  • Bachelor’s degree required; MBA, MPH, or PharmD preferred.

RxSense believes that a diverse workforce is a more talented and productive workforce. As such, we are an Equal Opportunity and Affirmative Action employer. Our recruitment process is free from discriminatory hiring practices and all qualified applicants are considered for employment without regard to race, color, religion, sex, gender, sexual orientation, gender identity, ancestry, age, or national origin.  Neither will qualified applicants be discriminated against on the basis of disability or protected veteran status.  We believe in the strength of the collaboration, creativity and sense of community a diverse workforce brings. 

In Office Policy:  Candidates within a commutable distance to one of the offices listed below will be expected to commit to a hybrid in office schedule if selected.

  • Boston, MA
  • Princeton, NJ
  • New York City, NY
  • West Palm Beach, Florida

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