Pillr Health

Director

• Negotiate and manage contractual agreements with national and regional payors and PBMs to gain and retain in-network access, understand 340B pricing and requirements.
• PBM reporting.
• Partner and work with multiple PSAO’s in the market
• Evaluate network participation criteria and lead submissions to meet access requirements, including credentialing, accreditation, and performance standards.
• Collaborate with legal, compliance, and finance teams to ensure contract terms are favorable and align with regulatory and operational standards.
• Maintain a comprehensive understanding of formulary structures, access restrictions, and rebate strategies that impact specialty pharmacy access.
• Serve as the primary liaison with payors and PBMs regarding contract performance, dispute resolution, and renewals.
• Analyze reimbursement rates, performance guarantees, and payor policies to optimize contract value and operational efficiency.
• Support business development by identifying new network opportunities and assisting with the launch of limited-distribution drug programs.
• Prepare reports and dashboards to communicate contract status, payor mix trends, and access barriers to internal stakeholders.

Senior Director, Pharmacy Accelerator – Payor Strategy

• Establish and maintain relationships with pharmaceutical manufacturers to gain access to limited distribution drugs (LDDs) critical for specialty pharmacy services.
• Support and coordinate completion of data intake forms, capability assessments, and site-of-care reviews required by manufacturers.
• Serve as the pharmacy's liaison for the manufacturer or GPO during credentialing and onboarding into LDD networks or preferred dispensing networks.
• Initiate and discuss contracts with manufacturers and GPOs.
• Ensure the pharmacy is aligned with right-tier pricing, contract terms, and rebate eligibility by maintaining compliant relationships and documentation.
• Track and interpret contract performance, ensuring the pharmacy meets volume or quality metrics tied to access.
• Coordinate with pharmacy leadership and compliance teams to ensure the organization is operationally aligned with manufacturer expectations, such as data reporting, REMS programs, or cold-chain handling.
• Monitor workflows that support successful drug procurement, inventory management, and patient safety protocols.
• Understand formulary management and drug tiering tied to Payors to support appropriate drug access.
• Facilitate and lead internal finance, clinical, operations, and reporting teams to deliver value story dashboards to manufacturers and GPOs—especially to show outcomes, adherence, and pull-through.

Senior Director, Pharmacy Accelerator – Payor Strategy

Senior Director, Pharmacy Accelerator, Manufacturer Relations