Manager II Managed Care Payment

Ahold - Quincy, MA

Full-time - Mid Level

Remote - Quincy, MA

Food and Beverage Retailers

About the position

The Manager II Managed Care Payment role at Ahold Delhaize USA is focused on enhancing the growth and profitability of Brand pharmacies through effective contracting and relationship management with Managed Care payers. This position involves negotiating contracts, managing pharmacy networks, and overseeing a team responsible for payment analysis and compliance. The role serves as the primary external contact for Brand pharmacies with Pharmacy Benefit Managers (PBMs) and other entities, ensuring alignment with strategic goals and financial objectives.

Responsibilities

• Manage activities supporting Brand participation in Managed Care pharmacy provider networks, including solicitation of provider agreements and contract management.
• Negotiate reimbursement rates and contract terms on behalf of Brand pharmacies.
• Provide financial analysis of solicitations and communicate findings to brands for budgeting and forecasting.
• Oversee pharmacy claims processing and contract performance management, including analysis of effective rate contracting.
• Build and maintain relationships with key payer network sponsors, including health plans and large employer groups.
• Accountable for the execution and retention of all payer network agreements for Brand pharmacies.

Requirements

• Bachelor's Degree
• 5+ years' financial services experience
• 5+ years of leadership experience
• Proficiency in Excel, including creating pivot tables and using VLOOKUP.

Nice-to-haves

• Relevant pharmacy industry experience
• Experience with negotiating contracts
• Understanding of P&L reports

Benefits

• Flexible/hybrid work schedule with 3 in-person days and 2 remote days
• Opportunities for personal and professional growth
• Support for Diversity, Equity, Inclusion and Belonging
• Wellness programs encompassing physical, financial, and emotional wellness