Pharmacy Network Consultant Principal - Remote

Our work matters. We help people get the medicine they need to feel better and live well.  We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

Job Description

The Network Management Consultant is responsible for development and management of Prime's pharmacy networks, aligning with Prime's supply chain and network economic objectives. This includes pharmacy relationship management, development of network agreements and network participation requirements, historical claims analysis, contract negotiations, and performance monitoring.

Responsibilities

• Negotiate market competitive and/or complex pharmacy agreements impacting multiple fulfillment channels with a focus on Medicare Part D (e.g., retail, mail, specialty).
• Serve as primary contracting representative for assigned chain pharmacies and/or PSAOs for Medicare Part D, Medicaid, and Commercial networks.
• Work closely with Prime's regulatory and legal teams to ensure all pharmacy contracts are in compliance.
• Effectively communicate all applicable contract details to Prime’s Pricing & Analytics and Operations teams.
• Other pharmacy network management duties as assigned .

Education & Experience

• Bachelor's degree in business or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required

• 8 years of provider network contracting and management, preferably within Pharmacy Benefits Management (PBM), healthcare or highly regulated industry.

Must be eligible to work in the United States without the need for work visa or residency sponsorship.

Additional Qualifications

• Excellent verbal and written presentation skills
• Demonstrated understanding of network reporting and analysis
• Demonstrated ability to establish trust and credibility; form working relationships with all levels of an organization
• Demonstrated ability to work independently and on highly complex agreements
• Strong attention to detail
• Solid time management skills with the ability to work on multiple projects simultaneously
• Demonstrated ability to problem solve and interpret complex data
• Ability to work with confidential data and maintain privacy

Preferred Qualifications

• Master's degree in business, healthcare or related area of study
• Demonstrated understanding of pharmacy network management
• 3 years of experience in commercial/Medicare Part D contracting

Physical Demands

• Ability to travel up to 15% of the time
• Constantly required to sit, use hands to handle or feel, talk and hear
• Frequently required to reach with hands and arms
• Occasionally required to stand, walk and stoop, kneel, and crouch
• Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Every 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.

Prime 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 (pregnancy, sexual orientation, and gender identity), 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.

Positions will be posted for a minimum of five consecutive workdays.