Job Details

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.Job Posting TitlePharmacy Network Consultant Senior - RemoteJob DescriptionThe Pharmacy Network Consultant Sr is responsible for development and management of Prime's retail, mail, specialty and quality-based pharmacy networks. This position is responsible for the management of Prime's network vendor's contracting activities ensuring contracting initiatives are effective and completed in accordance to Prime's Supply Chain Cost of Goods Sold (COGS) and network management strategies. This position is responsible for representing Network Management on financial audits and network management projects.ResponsibilitiesNegotiate market competitive low to medium-high complexity pharmacy agreements for assigned pharmacies across all channels including retail, mail, specialty and quality-based channels and lines of business aligned to Supply Chain COGS strategies and compliant with Network Management policiesCreate and manage network contracting campaigns with network vendor; analyze information and report contracting performance to Network Management leadership, Network Client Services, Network Financial Analytics, Supply Shared Services, Pharmacy FWA and Audit and other as identified; ensure all contracting initiatives meet competitive discounts and client goals for each campaignWork with Prime's reporting and analytics teams to establish network reporting for Prime and vendor's pharmacy networks composition to assess network adequacy, contracting gaps and compliance with regulationsRepresent Network Management department in audits and on cross-functional projects or Network Client Services initiativesPerform network development, network analysis and management activities supporting strategy and network management priorities and projectsEnsure all contractual obligations are in adherence with company policies, regulatory compliance and legal requirements and engage with Legal and Network Management leadership in negotiating non-standard contract language with pharmaciesEstablish, develop, and maintain relationships with chain, PSAOs and independent pharmacy providersManage all legal-to-legal correspondences between Prime and Pharmacy Providers escalating to Prime Legal Counsel as requiredOther duties as assignedMinimum QualificationsBachelor's degree in finance, business, management, or related field of study, or equivalent combination of education and/or related work experience; HS diploma or GED is required5 years of Network Management experience within Pharmacy Benefit Management (PBM), healthcare or other highly regulated industry; including 3 years of managed care experience in medical or pharmacy network contractingMust be eligible to work in the United States without the need for work visa or residency sponsorshipAdditional QualificationsExcellent verbal and written presentation skillsAbility to work independently and on highly complex contract language and agreements; strong attention to detailAbility to establish rapport and build relationships at all levels within an organizationEnhanced organizational skills with the ability to work on multiple projects simultaneouslyDemonstrated ability to problem solve and interpret complex data; ability to analyze network information and synthesize it into meaningful information for a variety of audiencesAbility to work with confidential data and maintain privacyAbility to evaluate and interpret policies and proceduresPreferred QualificationsMaster's degree in business, healthcare or related area of studyPharmacy contracting experience within a PBM or other related healthcare industryKnowledge of and experience within health care/PBM industry, Medicaid, Medicare and health plansFamiliarity with contract language and pharmacy reimbursement methodologiesEvery employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.Potential pay for this position ranges from $74,000.00 - $118,000.00 based on experience and skills.To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page ( and click on the "Benefits at a glance" button for more detail ( 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, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local 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.Positions will be posted for a minimum of five consecutive workdays.#J-18808-Ljbffr