Pharmacy Network Consultant Principal
New
P
Prime TherapeuticsPharmacy Benefit Management
United StatesFull-TimeSenior
Salary74,000 - 118,000 USD per year
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Job Details
- Experience
- 5 years of Network Management experience
- Required Skills
- Data AnalysisComplianceReporting
Requirements
- Bachelor's degree in finance, business, management, or related field (or equivalent combination of education and experience).
- 5 years of Network Management experience within Pharmacy Benefit Management (PBM), healthcare, or a highly regulated industry.
- 3 years of managed care experience in medical or pharmacy network contracting.
- Excellent verbal and written presentation skills.
- Ability to work independently on complex contract language and agreements.
- Strong attention to detail and ability to work with confidential data.
- Enhanced organizational skills with the ability to manage multiple projects simultaneously.
- Demonstrated ability to problem-solve and interpret complex data for various audiences.
- Ability to evaluate and interpret policies and procedures.
- Master's degree in business or healthcare preferred.
- Knowledge of Medicaid, Medicare, and health plans preferred.
- Familiarity with pharmacy reimbursement methodologies preferred.
Responsibilities
- Negotiate market competitive pharmacy agreements for retail, mail, specialty, and quality-based channels.
- Create and manage network contracting campaigns and report performance to leadership and internal partners.
- Collaborate with reporting and analytics teams to assess network adequacy and contracting gaps.
- Represent the Network Management department in audits and cross-functional projects.
- Perform network development and analysis activities supporting management priorities.
- Ensure contractual obligations adhere to company policies, regulatory compliance, and legal requirements.
- Establish and maintain relationships with chain, PSAOs, and independent pharmacy providers.
- Manage legal-to-legal correspondence and escalate issues to Legal Counsel as needed.
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