Prime Therapeutics
Sr. Director, Pharmacy Network Management - Remote
Prime Therapeutics, Lincoln, Nebraska, United States, 68511
Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
Sr. Director, Pharmacy Network Management - Remote
Job Description
The Senior Director of Network Management is responsible for creation and execution of network management strategies including retail, mail, specialty and quality-based networks. Accountabilities include team development and supervision, contracting and communication of network portfolio composition and value objectives. This position is responsible for oversight of Prime’s applicable network vendors to ensure market competitiveness, achieve network goals while ensuring compliance with applicable state and federal regulations. This individual is accountable for effective collaboration and coordination of activities with Network Operations, Provider Relations, Network Reporting and Analytics, Network Client Services, and Supply Chain Analytics.
Responsibilities
Oversee the negotiation of network agreements including retail, mail, specialty and quality based with select pharmacies yielding market competitive / market leading pharmacy reimbursement methodologies that support all of Prime’s business assuring coordination with performance standards and corporate goals.
Lead the development and implementation, in partnership with the AVP Network Management, of strategic initiatives concerning retail, specialty, mail, and quality/value-based network management to achieve Prime’s objectives.
Collaborate with the Provider Relations team to provide direction in managing effective pharmacy and corporate relationships driving a strong and sustainable supply chain and effectively manages Prime’s network performance, client network concerns and complaints, and all issues related to pharmacy participation and reimbursement.
Serve as a resource for escalated pharmacy or client issues.
Oversee the network management activities of Prime’s network vendors to achieve network objectives.
Supervise core and supplemental network contracting teams to ensure clarity of each role’s accountability and responsibilities
Provide leadership and direction to the Network Reporting Analytics team to ensure all performance guarantees, regulations, CMS start metrics and client contractual requirements are being met for pharmacy directories, access standards, etc.; establish pharmacy performance metrics and monitoring activities including; pharmacy score cards, vendor management, client score cards and efforts to improve the performance of both clients and networks.
Represent Network Management in key initiatives and partnerships and maintain key relationships with applicable stakeholders
Other duties as assigned
Minimum Qualifications
Bachelor’sdegreeinfinance,business,management,orrelatedfieldofstudy,orequivalentcombinationofeducationand/orrelatedworkexperience;HSdiplomaorGEDisrequired
10yearsofNetworkManagementexperiencewithinPharmacyBenefitManagement(PBM),healthcareorotherhighlyregulatedindustry
7yearsofprogressiveleadershipexperience
MustbeeligibletoworkintheUnitedStateswithouttheneedforworkvisaorresidencysponsorship
Additional Qualifications
Excellent verbal and written presentation skills
Expert negotiation and influencing skills
Strong attention to detail, organizational and time management skills
Demonstrated ability to apply critical thinking skills and problem solve through difficult situations
Leadership and motivational skills with proven ability to lead and motivate a team, serve as a mentor, develop people, and build a strong team
Demonstratedinterpersonaleffectivenesswiththeabilitytomeshclientandinternalbusinessworkingpartnerships
Well-developedanalytical,organizational,interpretive,andtime-managementskills
Abilitytosimultaneouslymanagemultipleprojectswithinstricttimelines
Abilitytoestablishrapportandbuildrelationshipsatalllevelswithinanorganization
Expert negotiation and influencing skills
Preferred Qualifications
MBA,othergraduatework,orequivalenttrainingand/orexperience
IntimateknowledgeofandexperiencewithinthePBMindustry,Medicaid,Medicare,andhealthplans
Familiaritywithcontractlanguageandriskmitigationconcepts
KnowledgeandexperienceinRetailPharmacy,orworkingwithRetailandChainproviderrepresentativesand/orProviderPerformanceIndicators
StrongunderstandingofthefinancialleversofPrimeanditscompetitors,andindustrystandards/trends
ExperienceworkingwithCommercialandMedicareand/orMedicaidprograms
Trackrecordofsuccessindealingeffectivelywithcomplexprojectsentailingfrequentinteractionwithexecutives
Minimum Physical Job Requirements
Ability to travel up to 20% of the time
Constantly required to sit, use hands to handle or feel, talk and hear
Frequently required to reach with hands and arms
Occasionally required to stand, walk and stoop, kneel, and crouch
Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus
Reporting Structure
Reports to Assistant Vice President in the Network Management department
Potential pay for this position ranges from $144,000.00 - $230,200.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/benefits) and click on the "Benefits at a glance" button for more detail.
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
Positions will be posted for a minimum of five consecutive workdays.
Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.
If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.
Job Posting Title
Sr. Director, Pharmacy Network Management - Remote
Job Description
The Senior Director of Network Management is responsible for creation and execution of network management strategies including retail, mail, specialty and quality-based networks. Accountabilities include team development and supervision, contracting and communication of network portfolio composition and value objectives. This position is responsible for oversight of Prime’s applicable network vendors to ensure market competitiveness, achieve network goals while ensuring compliance with applicable state and federal regulations. This individual is accountable for effective collaboration and coordination of activities with Network Operations, Provider Relations, Network Reporting and Analytics, Network Client Services, and Supply Chain Analytics.
Responsibilities
Oversee the negotiation of network agreements including retail, mail, specialty and quality based with select pharmacies yielding market competitive / market leading pharmacy reimbursement methodologies that support all of Prime’s business assuring coordination with performance standards and corporate goals.
Lead the development and implementation, in partnership with the AVP Network Management, of strategic initiatives concerning retail, specialty, mail, and quality/value-based network management to achieve Prime’s objectives.
Collaborate with the Provider Relations team to provide direction in managing effective pharmacy and corporate relationships driving a strong and sustainable supply chain and effectively manages Prime’s network performance, client network concerns and complaints, and all issues related to pharmacy participation and reimbursement.
Serve as a resource for escalated pharmacy or client issues.
Oversee the network management activities of Prime’s network vendors to achieve network objectives.
Supervise core and supplemental network contracting teams to ensure clarity of each role’s accountability and responsibilities
Provide leadership and direction to the Network Reporting Analytics team to ensure all performance guarantees, regulations, CMS start metrics and client contractual requirements are being met for pharmacy directories, access standards, etc.; establish pharmacy performance metrics and monitoring activities including; pharmacy score cards, vendor management, client score cards and efforts to improve the performance of both clients and networks.
Represent Network Management in key initiatives and partnerships and maintain key relationships with applicable stakeholders
Other duties as assigned
Minimum Qualifications
Bachelor’sdegreeinfinance,business,management,orrelatedfieldofstudy,orequivalentcombinationofeducationand/orrelatedworkexperience;HSdiplomaorGEDisrequired
10yearsofNetworkManagementexperiencewithinPharmacyBenefitManagement(PBM),healthcareorotherhighlyregulatedindustry
7yearsofprogressiveleadershipexperience
MustbeeligibletoworkintheUnitedStateswithouttheneedforworkvisaorresidencysponsorship
Additional Qualifications
Excellent verbal and written presentation skills
Expert negotiation and influencing skills
Strong attention to detail, organizational and time management skills
Demonstrated ability to apply critical thinking skills and problem solve through difficult situations
Leadership and motivational skills with proven ability to lead and motivate a team, serve as a mentor, develop people, and build a strong team
Demonstratedinterpersonaleffectivenesswiththeabilitytomeshclientandinternalbusinessworkingpartnerships
Well-developedanalytical,organizational,interpretive,andtime-managementskills
Abilitytosimultaneouslymanagemultipleprojectswithinstricttimelines
Abilitytoestablishrapportandbuildrelationshipsatalllevelswithinanorganization
Expert negotiation and influencing skills
Preferred Qualifications
MBA,othergraduatework,orequivalenttrainingand/orexperience
IntimateknowledgeofandexperiencewithinthePBMindustry,Medicaid,Medicare,andhealthplans
Familiaritywithcontractlanguageandriskmitigationconcepts
KnowledgeandexperienceinRetailPharmacy,orworkingwithRetailandChainproviderrepresentativesand/orProviderPerformanceIndicators
StrongunderstandingofthefinancialleversofPrimeanditscompetitors,andindustrystandards/trends
ExperienceworkingwithCommercialandMedicareand/orMedicaidprograms
Trackrecordofsuccessindealingeffectivelywithcomplexprojectsentailingfrequentinteractionwithexecutives
Minimum Physical Job Requirements
Ability to travel up to 20% of the time
Constantly required to sit, use hands to handle or feel, talk and hear
Frequently required to reach with hands and arms
Occasionally required to stand, walk and stoop, kneel, and crouch
Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus
Reporting Structure
Reports to Assistant Vice President in the Network Management department
Potential pay for this position ranges from $144,000.00 - $230,200.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/benefits) and click on the "Benefits at a glance" button for more detail.
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
Positions will be posted for a minimum of five consecutive workdays.
Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.
If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.