Director, Payer Programs - PBM Account Manager Contracting

Director, Payer Programs - PBM Account Manager Contracting

Lead the development and execution of contracting and pricing strategies for assigned key accounts, including PBM and Plans. You'll develop the business case behind each deal, showing how financials and terms impact other lines of business and aligning opportunities with Walmart's broader healthcare strategy. Collaborate closely with Finance, Underwriting, Operations, and Legal teams to develop account strategies that optimize profitability. Develop deep knowledge of assigned key accounts, including their challenges, contract terms, performance metrics, and growth opportunities, while serving as a key driver of immunization pharmacy and medical contracting.

What You'll Do...

• Oversee full lifecycle contract negotiations with PBM and health plans from new business and renewals to amendments and escalations on both the pharmacy and medical benefit.
• Develop deal "stories" and negotiation framework, ensuring alignment of proposed contracts to enterprise strategy
• Be the senior relationship owner for top-tier PBM accounts; develops account strategy, performance accountability, and growth initiatives. Transitioning the client relationship from transactional to solutions-oriented.
• Work in tandem with legal, pricing, finance, operations, and clinical teams to operationalize contract terms, implement changes, and mitigate reimbursement issues.
• Identify, pitch, and lead new contracting opportunities (e.g. immunization, value-based models, network expansion) to expand Walmart's role in payer-provider partnerships.

You'll join Walmart's Payer Relations team, a high-impact, cross-functional group that leads contracting strategy with PBMs, payers, and health plans. The team drives enterprise-level financial performance, ensures optimal reimbursement for pharmacy and medical services, and shapes strategic partnerships that advance Walmart's healthcare strategy. You will play a key role in elevating contracting rigor, implementing innovative payment models, and scaling immunizations service offerings.

What You'll Bring...

This position is based at our main corporate campus in Bentonville, Arkansas! We have an excellent relocation package to help you get here!

At Walmart, we offer competitive pay as well as performance-based bonus awards and other great benefits for a happier mind, body, and wallet. Health benefits include medical, vision, and dental coverage. Financial benefits include 401(k), stock purchase, and company-paid life insurance. Paid time off benefits include PTO (including sick leave), parental leave, family care leave, bereavement, jury duty, and voting. Other benefits include short-term and long-term disability, company discounts, Military Leave Pay, adoption and surrogacy expense reimbursement, and more. You will also receive PTO and / or PPTO that can be used for vacation, sick leave, holidays, or other purposes. The amount you receive depends on your job classification and length of employment. It will meet or exceed the requirements of paid sick leave laws, where applicable.

Minimum Qualifications...

Bachelor's degree business, finance, accounting, economics, or related area with 7 years' experience in managed care contracting / negotiations, healthcare billing, healthcare finance, or healthcare compliance / legal; or Ten years of relevant experience in managed care contracting / negotiations, healthcare billing, healthcare finance, or healthcare compliance / legal. Demonstrated experience in payer negotiations or relationship management; must be able to speak to concrete experiences and positive outcomes. Well-developed understanding of healthcare financing, revenue cycle processes and care delivery. Previous supervisory experience. Proficiency with all Microsoft tools.

Preferred Qualifications...

Experience with at least five of those years in a director or above role with a commercial or government program Payer or Provider Organization, Master's degree in Business, Healthcare, Finance, or related area, Supervisory experience

Primary Location...

2350 Grey Lag Way Road, Lexington, KY 40509-2477, United States of America Walmart and its subsidiaries are committed to maintaining a drug-free workplace and has a no tolerance policy regarding the use of illegal drugs and alcohol on the job. This policy applies to all employees and aims to create a safe and productive work environment.