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.

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