Director of PBM Network Pricing

Job Summary

Owning pharmacy network financial performance, the full-time remote Director of PBM Network Pricing will manage reconciliation and MAC pricing teams, ensuring effective rate guarantees and operationalizing network pricing strategies across all lines of business.

Key responsibilities

• Lead the Network Reconciliation function to validate pharmacy network performance against contracted effective rates and pricing guarantees
• Oversee the MAC Pricing team, ensuring competitive and compliant pricing that supports overall network financial targets
• Establish processes to monitor, measure, and report on network performance, driving corrective actions for identified variances

Required qualifications

• Bachelor's degree in Business, Finance, Economics, Healthcare Administration, or related field, or equivalent work experience
• 7+ years of progressive experience in PBM, healthcare plan, or pharmacy network management
• 3+ years of leadership experience with a track record of developing high-performing teams
• Demonstrated experience in pricing strategy and market analysis
• Experience supporting RFP pricing and competitive market analysis