Network Contracting Manager

Job Summary

Managing pharmacy contracts and relationships, the full-time Network Contracting Manager will negotiate reimbursement agreements, ensure compliance with regulations, and collaborate with clinical teams, all while working remotely.

Key responsibilities

• Negotiate pharmacy network reimbursement and execute pay for performance contracts
• Ensure compliance with regulatory entities and contractual obligations related to pharmacy networks
• Assist in determining pharmacy network reimbursement pricing structures and resolve contract issues

Required qualifications

• Bachelor's degree or higher in a related field is preferred
• Minimum 1 - 3 years of PBM or Managed Care experience is highly desired
• Understanding of managed care, retail, and specialty pharmacy network concepts is highly desired
• Experience with CMS, Medicare, and state Medicaid regulations is preferred
• Knowledge of health care processes and pharmaceutical claims adjudication systems