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Manager, Sr Pharmacy Contract - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Pittsburgh, PA Pittsburgh, Pennsylvania |
About this job
he Manager of Pharmacy Contracting will contribute to the growth of pharmacy sales by maximizing reimbursements through contract negotiations with key payers and insurers both regionally and nationally. This position is accountable for gaining contracts providing access to payer network lives in specialty, preferred and limited pharmacy networks.
Requirements
- Analyze and negotiate third party contracts valued greater than $300M each individually and totaling greater than 96% of total pharmacy revenue from all of the Prescription Benefit Managers (PBM) and third party insurances to obtain maximum reimbursements, maximize and maintain margins, and to maintain access in networks. Provide guidance to senior management regarding organizational impact & sales forecast for key payer contracts.
- Develop payer and employer strategy and lead efforts to secure entrance into limited pharmacy networks with top national and regional healthplans and employers in our footprint
- Develop payer strategy and lead efforts to secure specialty pharmacy contracts with payers.
- Creation and maintenance of services specific to payers. Drive performance of STARS programs in collaboration with Manager of Clinical Programs and Sr. Director of Pharmacy Administration
- New business development targeted but not limited to 340B, DME/medical billing with growth of at least 10 million.
- Support the Director of Managed Care with additional projects as they develop.
- Responsible for budget development, expense control and/or revenue generation for a department. Amount of Budgetary Responsibility: $5mm +
- Supervision of team members within an area or section of a department.
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