Senior Manager, Pharmacy Pricing

Role Overview

• In this multi-disciplinary, cross functional role, the Manager, Pharmacy Pricing will report to the Director, Pharmacy Pricing & Analytics.
• The Manager, Pharmacy Pricing is a leader and key contributor to the financial reporting and client retention process.
• This role is responsible for leading the team that executes, updates, and provides strategic direction for existing client pricing.
• The team also assists with resolving client issues involving performance discrepancies, claims issues, and reporting.
• The successful Pharmacy Pricing Senior Manager will be able to manage multiple projects at once, lead a team, and champion our mission and culture.
• Essential Job Responsibilities Include: End to end management of existing client pricing, analytics, and reporting.
• Leadership of the pricing team, consisting of up to 10 direct reports.
• This includes providing training, day-to-day direction, strategic vision, and mentoring/growth to all team members.
• Ability to lead with influence across internal stakeholders to foster collaborative and efficient work products.
• Review for accuracy and finalize all current account pricing comparisons for submission.
• Provide strategic insight and support the AM and Deal Governance teams for At-Risk accounts.
• Manage and support the current account claim and data requests.
• Respond to competing PBM offers to show RxBenefits pricing value and defend at-risk accounts.
• Prepare quarterly reports associated with financial performance.
• Lead the production and delivery of all current account annual renewal reporting (Pricing refresh & comparison).
• Support the PBM Pricing Analysts with validating new pricing products in Salesforce.
• Perform key audits for new pricing enrollments and monthly contract guarantee performance.
• Validate and test updates in SAS associated with pricing and exclusions to maintain reporting accuracy.
• Research and analyze discrepancies between projected rebates and payments received.
• Act as point of contact for the PBM partners to resolve pricing discrepancies.
• Model pricing improvements related to PBM negotiations for improved renewal pricing and terms.
• Identify gaps and opportunities in the current processes for enhanced visibility and efficiency.
• Act as a cross-functional representative throughout the organization to provide strategic insight and support organization goals and initiatives.
• Lead the development and application of advanced analytics techniques driving operational efficiencies, providing consultative support, enabling informed decision making, and producing KPIs for senior leadership.
• Analyze data to uncover potential issues / provide financial impacts.
• Provide custom analytics/modeling for ad-hoc projects.

Requirements

• 5+ years of actuarial or underwriting experience required
• 5+ years of PBM pricing or RFP experience required, large PBM experience desired
• 5+ years of leadership experience, preferably in PBM or Health Plan setting
• High degree of emotional intelligence
• Expert cross functional interpersonal, communication, and collaborative management skills
• Advanced knowledge of Microsoft Office, Advanced Excel experience required
• Proficient knowledge of SAS, SQL, Snowflake, or other data programming languages
• Strong team building, relationship management, and project management skills
• Independent/self-starting nature
• Process and procedure oriented
• Highly competent problem solver

Tech Stack

• SQL

Benefits

• Remote first work environment
• Choice of a HDHP or PPO Medical plan, we pay 100% of the premium for the HDHP for you and your eligible family members
• Dental, Vision, Short
• and Long-Term Disability, and Group Life Insurance that we also pay 100% of premiums (for your family too on Dental and Vision)
• Additional buy-up options for Short
• and Long-Term Disability and Life Insurance
• 401(k) with an employer match up to 3.5% available after 60 days
• Community Service Day to give back and support what you love in your community
• 10 company holidays including MLK Day, Juneteenth, and the day after Thanksgiving plus a floating holiday to use as you like
• Reimbursements for high-speed internet, we’ll send you a computer and monitors to help you do your best work
• Tuition Reimbursement for accredited degree programs
• Paid New Parent Leave that can be used for adoption or birth
• Pet insurance to protect your furbabies
• A robust mental health benefit and EAP service through Spring Health to support you when you need it most