Negotiate market competitive high-profile and/or complex pharmacy agreements across all channels including retail, mail, and quality based and lines of business aligning with Supply Chain COGS strategies
Lead and implement network initiatives by facilitating and performing network analyses, contracting activities and fee schedule development aligning with strategy, priorities and projects goals
Partner with Prime's reporting and analytics teams to develop network vendor loading rules inclusive of approved preferred pharmacies; maintain key compliance criteria and implement quarterly reporting processes for all contracted network retail pharmacies
Analyze network retail pharmacy quarterly reports to ensure compliance with reporting and participation requirements; collaborate with Clinical Program Directors to identify potential performance gaps; work with internal and external partners to develop and manage corrective action plans
Responsible for effectively managing the pharmacy contract from negotiation of all terms, ensuring Prime and Pharmacy compliance and document retention aligning with Prime's Record Information Management (RIM) policies
Work closely with Prime's legal team to update contract documents including agreements and applications for utilization in contracting/re-contracting activities based on new network participation requirements

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 Network Management experience within Pharmacy Benefit Management (PBM), healthcare or other highly regulated industry; including 5 years of managed care experience in medical or pharmacy network contracting
Must be eligible to work in the United States without the need for work visa or residency sponsorship
Excellent verbal and written presentation skills
Demonstrated understanding of network reporting and analysis for specialty pharmacy
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 contract language and agreements; strong attention to detail
Enhanced organizational skills with the ability to work on multiple projects simultaneously
Demonstrated ability to problem solve and interpret complex data; ability to analyze network information and synthesize it into meaningful information for a variety for audiences
Ability to work with confidential data and maintain privacy

Pharmacy Network Consultant – Principal

Key skills