Director, Business Services (Medicaid Operations)

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Director, Business Services (Medicaid Operations) based in the United States.

This senior leadership role sits at the center of Medicaid operations within a high-impact Business Services organization, shaping how complex rebate and contracting services are delivered to clients. You will act as a key subject matter expert, guiding operational excellence and ensuring industry-leading practices across Medicaid processes. The role combines strategic oversight with hands-on leadership, driving performance, compliance, and continuous improvement across teams and client engagements. You will partner closely with clients and internal stakeholders to strengthen relationships and ensure service quality in a highly regulated environment. With full ownership of delivery standards and operational outcomes, you will influence both day-to-day execution and long-term transformation. This is a fully remote opportunity for a leader who thrives in fast-moving, data-driven, and client-facing environments. The position also offers the chance to shape innovation in Medicaid operations, including automation and AI-enabled enhancements.

• Lead and define end-to-end Medicaid operations service delivery, ensuring high-quality outputs, strong client experience, and consistent adherence to SLAs and compliance requirements.
• Oversee the review and approval of Medicaid rebate deliverables, customer contracts, and data management activities within internal systems.
• Serve as the Medicaid subject matter expert, establishing best practices, advising stakeholders, and interpreting regulatory changes to ensure operational alignment.
• Drive operational excellence by improving processes, increasing efficiency, and promoting automation and continuous improvement across Business Services.
• Ensure compliance with SOC controls, internal policies, and applicable regulatory and contractual obligations.
• Lead and develop a high-performing team, fostering accountability, engagement, and continuous professional growth.
• Manage strategic client relationships, acting as a senior escalation point and ensuring resolution of complex inquiries and issues.
• Collaborate with cross-functional teams (including pricing, GTN, and product) to support system enhancements, AI adoption, and process optimization.
• Support change management initiatives and ensure successful adoption of new tools, workflows, and operating models.

Requirements:

• Bachelor’s degree in Accounting, Finance, Business, or a related field.
• 10+ years of experience in the pharmaceutical industry with deep exposure to Medicaid agreements and rebate operations.
• Proven leadership experience managing teams and client relationships in a complex, regulated environment.
• Strong subject matter expertise in Medicaid rebates, contracting, and claims-level validation processes.
• Demonstrated ability to lead operational transformation, drive process improvement, and act as a change agent.
• Strong analytical skills with the ability to work with large datasets and produce accurate, client-ready deliverables.
• Experience working in deadline-driven environments with multiple competing priorities.
• Solid understanding of compliance, regulatory requirements, and industry best practices.
• Advanced proficiency in Microsoft Office, particularly Excel, PowerPoint, and Word.
• Experience using generative AI tools to enhance productivity or decision-making is strongly valued.
• Excellent communication, organizational, and stakeholder management skills.
• Ability to travel approximately 10–20% as required.

Benefits:

• Competitive base salary range: $150,000 – $195,000 (based on experience, location, and qualifications)
• Unlimited PTO for salaried employees to support flexibility and work-life balance
• Comprehensive medical, dental, and vision insurance coverage
• Health Savings Account (HSA) and Flexible Spending Account (FSA) options
• 401(k) retirement plan with company match
• Volunteer Time Off (VTO) for community engagement
• Life insurance and pet insurance coverage
• Employee Assistance Program and mental health support resources
• Professional coaching and ongoing career development opportunities
• Charitable giving programs and additional wellness-focused benefits