Pharmacy Network Specialist
1 month ago
About the Job
The Pharmacy Network Management Specialist will be responsible for managing all aspects of the pharmacy network, including network pricing models and MAC management. They will work closely with the leadership team to identify network risks and develop strategies to mitigate them.
Key Responsibilities
- Develop and implement network pricing models and MAC management strategies
- Work with leadership to identify network risks and develop mitigation strategies
- Manage all SS&C MAC Lists, including developing strategies, pricing and balancing pharmacy contracts with customer guarantees
- Address and respond to MAC appeals meeting all state and other related regulatory requirements
- Create ad hoc reporting for network management and strategic analysis
- Ensure issues are identified, tracked, reported on and resolved in a timely manner
- Involvement in special projects, communication and overall organizational changes related to Pharmacy Networks
- Capacity to embrace change and quickly adapt to new situations, changes in direction, and altering priorities
- Identify Organization's strengths and weaknesses with regards to Pharmacy Networks and suggest areas of improvement
- Involvement in projects related to network management
- Partnering with other internal clients such as contract and legal teams to expedite the client contracting process
- Collaborate with other members of the finance team in budget, forecast, and compliance decisions
Requirements
- Degree in Business, Mathematics, Pharmacy, Actuarial Science or other related area or equivalent work-related experience
- Must have 3+ years' experience in Pharmacy Network MAC Management and Pharmacy Benefit Manager (PBM) experience
- Must be able to understand and evaluate risk
- 1+ years' experience with modeling and data management
- Advanced SQL, DB Visualizer and Excel skills required
- Tableau experience a plus
- Strong organizational and decision-making skills with a high degree of mathematical aptitude
- Strong understanding of pharmacy network processes
- Excellent written and oral communication skills
- Attention to detail
- Ability to interact with senior management and key business users
- Demonstrated ability to multi-task
- Experience with supporting and managing contractual guarantees
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