Sr. Director, Pharmacy Network Management - Remote

Prime Therapeutics • Providence, RI

474d • $144,000 - $230,200 • Remote

About The Position

The Senior Director of Pharmacy Network Management is responsible for developing and executing strategies for network management across various pharmacy types, including retail, mail, and specialty. This role involves overseeing vendor relationships, ensuring compliance with regulations, and collaborating with multiple departments to achieve network goals and enhance performance. The position requires strong leadership skills to manage teams and drive strategic initiatives that align with the company's objectives.

Requirements

• Bachelor's degree in finance, business, management, or related field; equivalent experience may be considered.
• 10 years of Network Management experience within Pharmacy Benefit Management (PBM) or a highly regulated industry.
• 7 years of progressive leadership experience.
• Eligibility 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/experience.
• Intimate knowledge of the PBM industry, Medicaid, Medicare, and health plans.
• Familiarity with contract language and risk mitigation concepts.
• 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 with Commercial and Medicare/Medicaid programs.
• Track record of success in managing complex projects with executive interaction.

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 effectively.
• 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.
• Perform other duties as assigned.

Benefits

• Health insurance
• Dental insurance
• Vision insurance
• 401k plan with matching
• Paid time off
• Flexible scheduling
• Professional development opportunities
• Employee discount programs

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Industry: Administrative and Support Services
• Education Level: Bachelor's degree