We're looking for a candidate to fill this position in an
Manage relationships with PBMs and payers to ensure pharmacy and
medical contracts and networks are effective and up to date to
support the national network of company pharmacies.
Support and contribute to the overall payer contracting strategy
and execution including negotiations, contract management, and
Monitor and analyze performance of third party payer agreements
including profitability, volume, strategic initiatives and contract
Lead contract review projects, complete thorough reviews of
existing contracts and provide executive summary reports outlining
opportunities for improvement.
Educate payers and develop the company’s brand and identity to
support the mission of a growing, customer-focused company.
Keep abreast of state and federal government legislation as well
as market dynamics to anticipate industry and payer trends.
Provide leadership and develop strategy for the pharmacy
licensing and contracting department. This team is responsible for
management of all pharmacy license applications, including state
Board of Pharmacy, Drug Enforcement Agency, business licensing,
network contracting, and other regulatory stakeholders.
Oversee the payer audits team, establish best in class
performance standards and implement processes to achieve
Enhance and broaden the company’s medical contracting
capabilities to generate additional business opportunities.
Collaborate with operations leadership to establish and execute
contracting initiatives and objectives, identifying and
prioritizing areas of focus.
5 years in pharmacy benefit management or pharmacy experience in
a health plan, with a strong understanding of the PBM contracting
process and prior negotiation of PBM contracts.
Experience in pharmacy licensing and familiarity with payer
audits process preferred
3-5 years managerial experience building and leading teams
Strong verbal and written communication skills including
presentation skills and payer/PBM relationship management
experience at an executive level
Strong financial analysis, problem-solving, organization,
critical thinking, and time management skills
Proficiency with Microsoft Excel, Word, Outlook, and
Highly developed relationship-building skills to foster
effective working relationships across company.
Undergraduate degree is required.
Advanced degree or MBA is highly desirable.
Requisition Number 879824
Job Family Network Contracting and Pricing