Sr. Director, Pharmacy Network Management - Remote

$144,000 - $230,200/Yr

Prime Therapeutics - Bismarck, ND

Full-time - Senior

Remote - Bismarck, ND

Administrative and Support Services

About the position

The Senior Director of Pharmacy Network Management is responsible for developing and executing strategies for managing pharmacy networks, including retail, mail, specialty, and quality-based networks. This role involves overseeing vendor relationships, ensuring compliance with regulations, and collaborating with various teams to achieve network goals and enhance performance.

Responsibilities

• Oversee the negotiation of network agreements with pharmacies to ensure competitive reimbursement methodologies.
• Lead the development and implementation of strategic initiatives for network management in collaboration with the AVP Network Management.
• Collaborate with the Provider Relations team to manage pharmacy and corporate relationships and address client network concerns.
• Serve as a resource for escalated pharmacy or client issues.
• Oversee network management activities of Prime's network vendors to achieve objectives.
• Supervise core and supplemental network contracting teams to clarify roles and responsibilities.
• Provide leadership to the Network Reporting Analytics team to ensure compliance with performance guarantees and client requirements.
• Represent Network Management in key initiatives and maintain relationships with stakeholders.

Requirements

• Bachelor's degree in finance, business, management, or related field; equivalent combination of education and experience accepted.
• 10 years of Network Management experience within Pharmacy Benefit Management (PBM) or a highly regulated industry.
• 7 years of progressive leadership experience.
• Must be eligible to work in the United States without the need for work visa or residency sponsorship.

Nice-to-haves

• MBA or other graduate work or equivalent training and experience.
• Intimate knowledge of the PBM industry, Medicaid, Medicare, and health plans.
• Familiarity with contract language and risk mitigation concepts.
• Knowledge and experience in Retail Pharmacy or working with Retail and Chain provider representatives.
• Strong understanding of financial levers in the industry and competitor standards/trends.
• Experience working with Commercial and Medicare and/or Medicaid programs.
• Track record of success in managing complex projects with executive interaction.

Benefits

• Health insurance
• Dental insurance
• Vision insurance
• 401k
• 401k matching
• Paid holidays
• Paid time off
• Flexible scheduling
• Tuition reimbursement
• Professional development opportunities