We’re building a new kind of pharmacy to cure one of our healthcare system’s most startling ills: over 50% of prescriptions are never picked up. Because staying on track with doctor’s orders requires more than just delivering pills, we’re managing everything from insurance logistics to pricing, late-night questions to supply chain, and anything else that could stand in the way of effective treatment. Our more than 700 employees are dedicated to fulfilling medicine’s true purpose: to improve the quality of life for everyone who needs it. We’ve filled over 1 million prescriptions to date. To aid our calling, we’ve raised $354 million in funding, and we’re on track to achieve $1 billion in annual recurring revenue (ARR) by 2021. Join us as we prove just how much a pharmacy can deliver.

Alto seeks a dynamic and energetic director level (individual contributor) Operational Excellence leader to support the achievement of industry leading effectiveness and efficiency across the rapidly growing care and fulfillment organizations. The position will support the successful deployment of the Alto Business System (ABS), which will enable the business to effectively scale from $200M to $20B in annual revenue. This transformation will enhance Alto’s operations, enabling the business to maintain and enhance the patient & provider experience during a period of explosive growth. 

At Alto, culture is one of the key differentiators enabling the company to disrupt the entrenched competition.  The successful candidate will fit into and strengthen the culture while balancing the requirement to aggressively drive change across people, process, and technology. The Operational Excellence Lead will be single minded in their execution of initiatives to increase company productivity and effectiveness, improve process efficiency, and deliver against immediate and critical long-term milestones. Key responsibilities will include project managing the execution of operational excellence projects and fostering accountability, operational excellence, and fast-cycle improvement.


  • As the Operational Excellence leader you will scope, execute and facilitate Lean-based continuous improvement initiatives.  This leader will establish and build effective relationships with the Care Operations and across the company including Product and Engineering, Fulfillment, Finance, Marketing, and HR, working in close partnership to coach and mentor the teams on process improvement and business excellence efforts.  
  • Develop the Alto Business System.  Drive teaching for Operational Excellence. Train and develop staff (from Management to entry-level) on Lean, TPS, TPM, Six Sigma principles, creating a cultural transformation and Lean-based continuous improvement mindset. Mentor Alto Pharmacy staff in lean principles and drive adoption of standard work systems into the daily work and habits of the Pharmacy
  • Lead key strategic projects. Drive improvements to the effectiveness, efficiency, profitability, and lifetime value of both Patient and Provider relationships. Work to enhance and strengthen the deep relationships that Alto has built with critical stakeholders across the value chain. 
  • Actively find new opportunities for process improvement. Identify and scope new project areas that eliminate rework, waste, and over processing to deliver best-in-class operational performance.  
  • Lead the implementation of new systems and process as well as the elimination of manual or ad hoc practices to reduce process variance and streamline operations.  
  • Drive the development, deployment, and monitoring of KPIs tied to strategic goals, as well as evaluation of team performance against these metrics. 
  • Organize focus on sustainability of gains through standard work concepts 
  • Drive the development, deployment, and monitoring of KPIs tied to strategic goals, as well as evaluation of team performance against these metrics. 
  • Utilize dynamic visual management to drive real-time performance accountability. 
  • Implement effective governance models and processes to ensure excellence across all sites as the firm rapidly scales.
  • Collaborate, consult and influence management in a cross-functional environment. Ability to challenge business leaders at all levels while building relationships and gaining respect.
  • Strict adherence to the Company’s corporate policies and all regulatory requirements.

A bit about you:

Minimum Qualifications:

  • A minimum of 7 to 10+ years’ experience in operations management with direct experience in the implementation of Lean-based continuous improvement programs.
  • Certification in process improvement (e.g. Lean Expert, Black Belt, Master Blackbelt)
  • Business process improvement experience in a customer-centric, tech-enabled, call center environment.  
  • Demonstrated ability to successfully execute large, complex change efforts in a rapidly scaling business. 
  • Hands on experience in lean manufacturing implementations, including analysis, design and implementation
  • Deep experience in project and program management methodologies, tools, and technologies. 
  • Ability to travel up to 50%

Preferred Qualifications:

  • Undergraduate degree in Operations Management or Engineering preferred. Advanced degree or MBA preferred. 
  • Prior experience working with private equity or in fast-paced mid-sized companies is a plus.
  • Master Black Belt certification preferred.

Alto Pharmacy is an Equal Opportunity Employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, genetic information, age, disability, veteran status, or any other legally protected basis. 

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. We are an E-Verify company.

Apply for this Job

* Required


Demographic Questions
Help Alto be an equal opportunity employer!
Individuals seeking employment at Alto Pharmacy are considered without regard to race, color, religion, national origin, age, sex, marital status, ancestry, physical or mental disability, veteran status, gender identity, or sexual orientation.You are being given the opportunity to provide the following information in order to help us comply with federal and state Equal Employment Opportunity/Affirmative Action record keeping, reporting, and other legal requirements.
  • Completion of these questions is entirely voluntary. There will be no impact on your candidacy if you choose not to answer any of these questions.
  • No hiring decisions are made based on this information. Your responses will not be visible to anyone on the hiring team, nor to anyone who can influence your interview process. 
  • Any information you share below is anonymized and aggregated in order to preserve privacy and is never associated with your application or personal identifying information.
Alto is committed to providing an equitable and inclusive interviewing experience and work environment. Thank you for helping us to ensure equal employment opportunities for all!
Please specify your ethnicity [select all that apply]:

Please specify your gender identity

Do you identify as LGBTQIAP+?

Do you have military experience of any kind?

Do you identify with any of the following?

Please specify your age group