Pharmacy Network Manager

Job Summary

A company is looking for a Process Manager (PBM Operations and Oversite Manager).

Key Responsibilities

• Manage contracts with pharmacy providers across multiple network types (retail, mail-order, specialty)
• Oversee and support credentialing, re-contracting, and termination processes with network pharmacies
• Monitor and evaluate network performance metrics such as claims volume, turnaround times, network adequacy, and member satisfaction

Required Qualifications

• Minimum 8 years of relevant experience in healthcare, pharmacy benefit management (PBM), or pharmacy network operations
• Bachelor's Degree in Computer Science, Information Technology, or related field
• In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required
• Strong understanding of pharmacy networks and provider management
• Familiarity with pharmacy contract terms and service-level agreements (SLAs)