Senior Pharmacy Call Center Manager – Remote OH

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

Gainwell Technologies is seeking a Senior Pharmacy Call Center Manager to lead operations for our Single Pharmacy Benefit Manager (SPBM) Call Center, serving the Ohio Department of Medicaid. In this role, you will provide strategic and operational leadership to ensure timely and accurate resolution of inquiries from members, prescribers, pharmacies, and Managed Care Plans. You’ll oversee call center metrics, drive service-level agreements (SLAs), and foster a culture of excellence, compliance, and continuous employee development.

Your role in our mission

• Lead the SPBM call center team with effective hiring, onboarding, training, coaching, and recognition programs.
• Manage real-time performance and resource allocation to consistently meet and exceed SLA requirements.
• Ensure inquiries from members, providers, and partners are accurately researched, documented, and resolved on time.
• Maintain and update policies, procedures, and work instructions in compliance with state requirements.
• Partner with Quality Assurance (QA) and Quality Improvement (QI) teams to identify trends and drive continuous improvement.
• Develop and deliver reporting to leadership and client stakeholders that highlights performance, challenges, and opportunities.

What we’re looking for

• Bachelor’s degree in Business, Healthcare, Insurance, or related field preferred (or equivalent work experience).
• Must-Haves: Previous call center experience and proven leadership experience are required; pharmacy or PBM experience strongly preferred.
• 1–2 years of managed care, insurance, or PBM call center leadership experience.
• Demonstrated ability to manage supervisors and staff to meet productivity and performance goals.
• Experience with Medicaid programs, SPBM UPDL criteria, and/or prior authorization decisioning is a plus.
• Strong communication and collaboration skills, with the ability to work across teams and with external clients.

What you should expect in this role

• Remote position aligned to Eastern Standard Time (EST) operations: 8:00 AM – 5:00 PM.
• Reliable home internet required: minimum 24 Mbps download / 8 Mbps upload (higher speeds strongly recommended).
• Business travel required, including monthly and quarterly trips to the Dublin, Ohio office.
• Regular meetings with state representatives to review compliance, updates, and performance metrics.
• Fast-paced environment requiring flexibility, accountability, and a strong customer service mindset.
• Opportunities to collaborate with cross-functional teams to drive best practices and innovation in customer support.

The pay range for this position is $75,700.00 – $108,100.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

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