AVP Claims & Configuration - REMOTE

For our client, we are seeking a AVP Claims & Configuration - REMOTE to join the team of a leader in the Pharmaceuticals & Biotech space. This role will advance people and talent initiatives that strengthen organizational effectiveness, leadership capability, and employee experience. You will collaborate with business leaders, HR partners, and cross-functional stakeholders to align workforce priorities with business objectives. The position offers the opportunity to influence culture, talent strategy, and scalable people operations within a life sciences environment.

Location: Remote - US based candidates only, no visa sponsorship available

Compensation: $164,000 – $279,000 annually

Responsibilities

• Lead cross-functional teams for claims adjudication and benefit configuration
• Drive modernization initiatives for operational efficiency and customer experience
• Own strategy execution for pharmacy claims and benefit configuration
• Oversee accurate interpretation of client benefit plans and clinical programs
• Collaborate with internal partners for operational transformation
• Establish and monitor metrics for claims accuracy and compliance
• Lead initiatives to simplify processes and reduce operational risks

Qualifications

• Bachelor’s degree in Business, Health Care Administration, or related area; HS diploma or equivalent required
• 12 years of experience in PBM, health plan, or healthcare operations
• 8 years of leadership/people management experience
• Must be eligible to work in the U.S. without sponsorship
• Strong understanding of pharmacy benefit administration and claims processing

Benefits

• Comprehensive health benefits and wellness programs
• Flexible work arrangements with remote options
• Professional development and training opportunities
• Support for work-life balance with generous vacation policies
• Retirement savings plan with company contributions

Our client is an equal opportunity employer. We encourage you to apply even if you don’t meet every qualification—your background could be exactly what this team needs.