Director, Pharmacy Networks
Rightway
full-time
Posted on:
Location Type: Remote
Location: Florida • United States
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Salary
💰 $160,000 - $180,000 per year
Job Level
About the role
- Oversee networks, adjudication, and pharmacy network configuration while monitoring performance metrics and implementing improvement strategies
- Oversee and manage pharmacy audits, develop audit protocols, and ensure adherence to regulatory requirements and industry standards
- Negotiate contracts for the entire pharmacy network and lead strategic relationship management with key pharmacy partners
- Develop pricing strategies and guardrails for contracting, lead pharmacy rate negotiations, and serve as final contract approver
- Partner with Finance and Accounting teams on pharmacy remittances, payments, and other financial reporting
- Coordinate specialty negotiation strategy with specialty pharmacy teams while collaborating closely with internal Rightway specialty operations team
- Oversee pharmacy analytics and compliance reporting, generating performance reports and providing data-driven insights for strategic decision-making
- Collaborate cross-functionally with internal teams to drive operational excellence and ensure contract terms align with Rightway's business objectives
- Other duties as assigned to support Rightway's mission and objectives
Requirements
- Bachelor's degree in Business Administration, Healthcare Management, Pharmacy, or related field; Master's degree preferred
- 7+ years of experience in pharmacy benefit management, healthcare contracting, or provider relations
- 3+ years of leadership/management experience with demonstrated ability to oversee cross-functional teams
- Proven experience in contract negotiation and vendor relationship management
- Strong background in pharmacy operations, network management, and adjudication processes
- Experience with pharmacy audits, compliance reporting, and regulatory requirements
- Proficiency in data analytics and reporting tools with ability to translate data into actionable insights
- Knowledge of healthcare regulations, pharmacy benefit laws, and industry compliance standards
- Excellent communication, negotiation, and stakeholder management skills
- Strong analytical and problem-solving abilities with attention to detail
- Ability to work in a fast-paced environment and manage multiple priorities effectively.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
pharmacy benefit managementcontract negotiationvendor relationship managementpharmacy operationsnetwork managementadjudication processespharmacy auditscompliance reportingdata analyticsfinancial reporting
Soft skills
leadershipcommunicationnegotiationstakeholder managementanalytical abilitiesproblem-solvingattention to detailoperational excellencecollaborationtime management