Pharmacy Network Management Consultant - Remote

Pharmacy Network Management Consultant - Remote

Our work matters. We help people get the medicine they need to feel better and live well. It fuels our passion and drives every decision we make.

The Network Management Consultant is responsible for development, performance, and management of Prime's retail, mail, specialty, and quality-based networks aligning with Prime's Supply Chain Cost of Goods Sold (COGS) and network management strategies. This includes development of network contracts, participation requirements, analysis of pharmacies, and ensuring contract and regulatory compliance. This position is accountable for the creation and management of specialty fee schedules to ensure competitiveness and serves as the liaison between Prime's Network Management and Specialty teams.

Responsibilities include :

• Negotiating market competitive high-profile and / or complex pharmacy agreements across all channels including retail, mail, specialty, and quality based and lines of business aligning with Supply Chain COGS strategies
• Leading and managing specialty fee schedule development process and ensuring fee schedule revisions align with Supply Chain COGS strategies for specialty drug management
• Leading and implementing network initiatives by facilitating and performing network analyses, contracting activities, and fee schedule development aligning with strategy, priorities and project goals
• Partnering with Prime's reporting and analytics teams to develop network vendor loading rules inclusive of approved preferred and specialty pharmacies; maintaining key compliance criteria and implementing quarterly reporting processes for all contracted network specialty pharmacies
• Analyzing network specialty pharmacy quarterly reports to ensure compliance with reporting and participation requirements; collaborating with Specialty Clinical Program Directors to identify potential performance gaps; working with internal and external partners to develop and manage corrective action plans
• Managing the pharmacy contract effectively from negotiation of all terms, ensuring Prime and Pharmacy compliance and document retention aligning with Prime's Record Information Management (RIM) policies
• Working 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
• Other duties as assigned

Education & Experience :

Additional Qualifications :

Preferred Qualifications :

Physical Demands :

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.