Pharmacy Network Consultant – Principal
Prime Therapeutics
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $94,000 - $160,000 per year
Job Level
About the role
- Negotiate market competitive high-profile and/or complex pharmacy agreements across all channels including retail, mail, and quality based and lines of business aligning with Supply Chain COGS strategies
- Lead and implement network initiatives by facilitating and performing network analyses, contracting activities and fee schedule development aligning with strategy, priorities and projects goals
- Partner with Prime's reporting and analytics teams to develop network vendor loading rules inclusive of approved preferred pharmacies; maintain key compliance criteria and implement quarterly reporting processes for all contracted network retail pharmacies
- Analyze network retail pharmacy quarterly reports to ensure compliance with reporting and participation requirements; collaborate with Clinical Program Directors to identify potential performance gaps; work with internal and external partners to develop and manage corrective action plans
- Responsible for effectively managing the pharmacy contract from negotiation of all terms, ensuring Prime and Pharmacy compliance and document retention aligning with Prime's Record Information Management (RIM) policies
- Work closely with Prime's legal team to update contract documents including agreements and applications for utilization in contracting/re-contracting activities based on new network participation requirements
Requirements
- Bachelor's degree in business or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
- 8 years of Network Management experience within Pharmacy Benefit Management (PBM), healthcare or other highly regulated industry; including 5 years of managed care experience in medical or pharmacy network contracting
- Must be eligible to work in the United States without the need for work visa or residency sponsorship
- Excellent verbal and written presentation skills
- Demonstrated understanding of network reporting and analysis for specialty pharmacy
- Demonstrated ability to establish trust and credibility; form working relationships with all levels of an organization
- Demonstrated ability to work independently and on highly complex contract language and agreements; strong attention to detail
- Enhanced organizational skills with the ability to work on multiple projects simultaneously
- Demonstrated ability to problem solve and interpret complex data; ability to analyze network information and synthesize it into meaningful information for a variety for audiences
- Ability to work with confidential data and maintain privacy
Benefits
- Health insurance
- 401(k) matching
- Flexible work hours
- Paid time off
- Remote work options
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
network managementpharmacy benefit managementcontract negotiationdata analysiscompliance managementfee schedule developmentreporting processescorrective action planscontract documentationnetwork vendor loading rules
Soft Skills
verbal communicationwritten communicationrelationship buildingindependent workattention to detailorganizational skillsproblem solvingtrust and credibilitysynthesis of informationability to work on multiple projects