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Walmart Canada · 1 day ago

Senior Manager, Payer Programs

Bentonville, AR

Full-time

Onsite

Senior Level

5+ years exp

Walmart Inc. is expanding its Health & Wellness services and is looking for a Senior Manager, Payer Programs to lead payer program implementation and ensure operational readiness for pharmacist-delivered clinical services. This role involves collaborating with various teams to align payer and provider requirements, enhancing program performance, and ensuring compliance with payer requirements.

DeliveryRetailShopping

Responsibilities

Lead and coordinate operational readiness and implementation activities for new and renewing payer programs, ensuring requirements are fully understood, documented, and executed with cross-functional alignment

Serve as the primary liaison between payer teams, external partners, and internal stakeholders, resolving escalated issues and driving operational consistency and performance

Develop and deploy chainwide processes, workflows, and provider-facing materials to support compliance with payer requirements and successful program execution

Monitor payer policies, provider materials, and performance metrics, applying best practices to identify risks, mitigate issues, and optimize ongoing operations

Coordinate and lead Quarterly Business Reviews (QBRs) with external payer partners, synthesizing input from internal stakeholders to review performance metrics, resolve issues, and inform improvement initiatives

Collaborate with internal and external partners to streamline workflows, enhance program performance, and support high-quality patient outcomes

Qualification

Payer program implementationHealthcare reimbursement modelsPharmacy operationsStakeholder engagementProject managementData analysisCommunication skills

Required

5+ years of experience in pharmacy operations, pharmacist clinical services, payer program implementation, payer provider relations or managed care-related roles

Demonstrated success operationalizing payer requirements and deploying clinical programs at scale across complex healthcare environments

Strong understanding of healthcare reimbursement models, payer-driven requirements, and regulatory and compliance considerations for pharmacist-delivered services

Advanced communication, stakeholder engagement, and project management skills, with the ability to influence clinical, operational, and external partner teams

Ability to analyze operational and performance data, identify risks and opportunities, and drive continuous improvement in payer program execution