Health Plans General Manager

Summary

Join RxSense as their Health Plan General Manager, an executive role blending operational leadership with a strong go-to-market and business development focus. Oversee health plan client operations while driving growth through engagement with health plans, PBMs, consultants, and brokers. Manage client performance and lead sales strategies to expand the company's presence in the payer market. This position requires experience in pharmacy benefit management, proven success in go-to-market initiatives, and a deep understanding of pharmacy benefit structures and regulations. The ideal candidate will possess strong executive presence, communication, and negotiation skills. RxSense offers a dynamic work environment and has received several prestigious awards.

Requirements

• 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
• 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

Responsibilities

• 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
• 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
• 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

Preferred Qualifications

Established relationships with PBM consultants, brokers, or payers strongly preferred