Vice President, Pharmacy

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.

About the Opportunity 

At Machinify, we’re constantly reimagining what’s possible in our industry—creating disruptively simple, powerfully clear ways to maximize our clients’ financial outcomes today and drive down healthcare costs tomorrow. As part of the Pharmacy team, you will lead and scale our pharmacy operations organization. This is a senior leadership role for an operator who is equally comfortable in a client-facing strategy conversation and in the production system reviewing a claim line by line. 

The VP owns the performance, culture, and continuous improvement of a multi-layered pharmacy payment integrity organization that serves U.S. health insurers, employers, and pharmacy benefit managers by identifying, recovering, and preventing pharmacy claim overpayments.  This role has significant autonomy and significant expectations. Success is measured in recovery performance, operational efficiency, and the strength of the team you build. 

What you’ll do 

People Leadership 

• Lead a pharmacy operations organization with direct reports ranging from Senior Manager through Director level, and overall accountability for the broader team beneath them.
• Build and sustain a culture that holds team members to demanding performance standards while making Machinify a place people want to work. These are complementary objectives.
• Coach and train managers to recognize underperformance early and conduct clear, constructive, well-documented performance conversations.
• Recognize and publicize excellent work; create visible standards for what great performance looks like.
• Champion and lead employee engagement and cultural initiatives; remain visible and accessible to employees at every level of the organization.
• Partner closely with People Operations on hiring, workforce planning, policy development, and consistent enforcement of expectations.

Workflow and Performance Optimization 

• Continuously identify efficiency opportunities across pharmacy operations workflows and eliminate steps that do not create value.
• Re-engineer unnecessarily manual processes, selecting the most effective solution path for each problem:
  • Applying an existing internal or vendor tool that directly solves the problem
  • Repurposing or extending an existing tool
  • Partnering with Software Engineering to scope and prioritize a custom solution
• Identify, codify, and teach superior operating techniques — from call handling and verbal persuasiveness to efficient system navigation and parallel task execution.
• Set, communicate, and manage to clear performance expectations and productivity targets across recovery outcomes, case throughput, and outbound contact activity.
• Use operational data to diagnose root causes rather than symptoms, and to prioritize where improvement effort is spent.

Senior Leadership and Cross-Functional Execution 

• Independently own strategic initiatives end to end: build the plan, assign responsibilities, sequence the work, and drive cross-functional collaboration to implement change quickly and durably.
• Serve as a communications leader internally, including regular presentation at All Hands and other company-wide forums.
• Interface directly with clients and with the Executive Leadership Team; act as a primary presenter on external client and sales calls as needed.
• Bring the operational point of view into company-level strategy, technology roadmap, and client commitment discussions.

What experience you bring (Role Requirements) 

Required 

• Progressive leadership experience in pharmacy operations, pharmacy benefit management, healthcare claims, payment integrity, or a closely related operational domain, including experience managing managers.
• Demonstrated track record of improving operational performance — measurable gains in productivity, quality, recovery, or cost — through process redesign rather than headcount alone.
• Working fluency with operational systems and data: able to learn a new platform quickly, work in it directly, and identify errors and inefficiencies without relying solely on delegated answers.
• Experience partnering with technology teams to define requirements and deliver tooling or automation improvements.
• Executive-level written and verbal communication skills, with experience presenting to senior leadership and to external clients.
• Experience building and executing consistent, well-documented performance management processes.

Preferred 

• Direct experience in pharmacy claims review, prescription drug recovery, or PBM audit environments.
• Familiarity with the regulatory environment, reimbursement mechanics, claims auditing, coordination of benefits (COB), and compensation structures relevant to healthcare claims or pharmacy benefits.
• Demonstrated performance in accounts receivable management (ARM), overpayment recovery, or revenue cycle management.
• Experience scaling an operations team through a period of rapid growth or significant process change.
• Clinical pharmacy credentials (PharmD, RPh, or CPhT) are a plus but not required.

What We Look For 

The following describes how the most successful leaders operate in this role. 

• Competitive and performance-driven. You treat the organization’s success as its own reward. You keep your foot on the accelerator and do not assume any part of the status quo is correct simply because it exists.
• Close to the work. You can work a file, navigate the system, and spot an error someone else made. You are not dependent on secondhand answers. Where expertise is missing, you shadow the people doing the work and quickly develop proficiency, because knowing the work firsthand is what makes you both a credible manager and an effective process designer.
• You pair ground-level process knowledge with a senior grasp of technology, industry rules and opportunities, economics, and client expectations. You think critically about the business’s hardest problems and bring solutions, not just escalations.
• Compassionate but clear-eyed. You care about every person on your team and build an environment where people feel genuinely supported. You also act decisively and fairly when someone is not the right fit for the role, following a consistent and respectful process.
• Comfortable with ambiguity and ownership. You are given goals rather than instructions, and you prefer it that way.

Pay range: $150,000 - $225,000 USD.  This is an exempt position and salary range is for base salary. Compensation will be determined based on several factors including, but not limited to, skill set, years of experience, and the employee’s geographic location. 

What’s in it for you    

• PTO, Paid Holidays, and Volunteer Days
• Eligibility for health, vision and dental coverage, 401(k) plan participation with company match, and flexible spending accounts
• Tuition Reimbursement
• Eligibility for company-paid benefits including life insurance, short-term disability, and parental leave.
• Remote and hybrid work options 

What values we’ll share with you 

• Ask why
• Think big
• Be humble
• Optimize for customer impact
• Deliver results

Equal Employment Opportunity at Machinify

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/