VP, Health Plan & PBM Relations

VP, Health Plans & PBM Relations

AnewHealth is one of the nation's leading pharmacy care management companies that specializes in caring for people with the most complex, chronic needswherever they call home. We enable better outcomes for patients and the healthcare organizations who support them. Established in 2023 through the combination of ExactCare and Tabula Rasa HealthCare, we provide a suite of solutions that includes comprehensive pharmacy services; full-service pharmacy benefit management; and specialized support services for Program of All-Inclusive Care for the Elderly. With over 1,400 team members, we care for more than 100,000 people across all 50 states.

The VP, Health Plans & PBM Relations will lead the development and management of strategic partnerships with health plans, PBMs, and other key external stakeholders to drive demand for AnewHealth services. This role will manage contracting and negotiations and provide strategic guidance on market trends, policy changes, and reimbursement strategies. The VP will work closely with internal teams to align business goals, market segment strategies, and growth initiatives, while ensuring service excellence and cross-functional collaboration. Additionally, this leader will contribute to the annual planning, forecasting, and budgeting processes and foster a high-performing, engaged team. This role requires intense cross-functional collaboration and leadership of industry, products, and people.

Responsibilities

• Solve patient experience barriers with health plans including co-pay differential and medication synchronization fulfillment timing / overrides
• Establish and manage payer performance expectations including STARS, outcomes, and value-based programs (e.g., quality bonus programs)
• Build relationships with key external partners in market access, including Health Plans, PBMs, to stimulate, surface, and shape demand for AnewHealth services, exploring new opportunities for value creation and ensuring service levels (e.g., QBRs).
• Identify new partners within the organization and partners with growth leaders to propose services.
• Stay on top of trends and information with health plans and PBMs that can impact the business, keeping leadership and key stakeholders informed of changes (e.g. policy, reimbursements)
• Interpret the impact of marketplace changes and advise leadership on how to react and position the business.
• Provide strategies and growth plans for market segments (e.g., Nationals, Blues, SNP Plans, Medicaid, etc.) that inform business goals, focus areas, closing strategies, capabilities, and activities.
• Own the contracting and negotiation with reimbursement partners including comprehensive contract lifecycle management.
• Actively contribute to the annual brand planning, forecasting, and budgeting process.
• Recruit, motivate, and retain a high-performing organization, ensuring cross-functional knowledge and mastery of communicating key concepts, driving employee engagement, satisfaction, and morale.

Qualifications

Skills & Abilities

Physical & Mental Demands

Schedule

Travel

AnewHealth offers a comprehensive benefit package for full-time employees that includes medical / dental / vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental, and vision coverage are effective 1st of the month following date of hire.

AnewHealth provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants are encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.