Pharmacy Network Manager

PLEASE NOTE: THIS ROLE IS WITH A PHARMACY BENEFIT MANAGEMENT ORGANIZATION - NOT 'BRICK AND MORTAR' RETAIL PHARMACY COMPANY

Adecco Perm Practice, in partnership with its client, is on the hunt for great candidates, one of whom will fill the role of Pharmacy Network Manager. In this job, you will be the liaison between the company and network pharmacies. You'll be responsible for cultivating and maintaining a positive working relationship, to include: management of the pharmacy network, contract negotiations, rate analysis, utilization, issue resolution, and all maintenance and communication with network pharmacies.

You will

Manage the setup, administration, and maintenance of the pharmacy network adjudication program; auditing pharmacy provider contracts as necessary.
Manage a comprehensive approach and specific plan to pharmacy recruitment to build and maintain a pharmacy network.
Perform outreach to potential network candidates, employing effective sales and presentation skills as needed.
Manage negotiation and contracting with potential network participants: establishing appropriate contracted rates for pharmacy reimbursement, handling re-negotiations, and integrating contract requirements with business operations.
Ensure appropriate communication to the pharmacy network at all times.
Establish procedures as they relate to the accurate adjudication of claims; develop internal workflows, and maintain SOPs for all pharmacy network activity.
Develop prospective client pricing proposals, and rate analysis as necessary.
Maintain an active relationship with pharmacy providers throughout the organization, coordinate and partner with internal stakeholders as necessary to ensure the highest level of service to pharmacy network clients
Maintain communication with internal departments and stakeholders to ensure understanding of mission-critical technical functions and skills in order to fully comprehend how the business operates, proficiently employ methods and technologies, and expertly reiterate the Company model and value to network clients in order to support the Company’s marketplace position, growth, and profitability.

You are responsible for all client implementations: ensuring plan design, setup, and testing, meeting go-live needs, partnering with internal stakeholders and departments efficiently and positively as needed to ensure clients experience a positive, streamlined, and impressive implementation process.

Manage effective relationships with internal stakeholders and departments to ensure effective implementation of contracts.
Continuously monitor program compliance: understanding and monitoring legislative changes to ensure compliance, actively responding to changes with proposed internal augmentation, and successfully executed internal augmentation as approved.
Manage operational reporting and metrics.
Drive integration related projects as needed and as assigned.
Travel to expand and maintain pharmacy network, attending attend trade shows, conferences, meetings, and other events as relevant, needed, or assigned.
Supports company pharmacy network by completing other duties as assigned and as needed.

Required Qualifications/Attributes

Ability to analyze and synthesize information to understand issues and identify options.
Ability to promote ideas persuasively; shape stakeholder opinions and negotiate skillfully to create the best outcome
Understand various types of business propositions and understand businesses
Understands applicable laws and regulations concerning pharmacy network management.
Ability to relate well to a wide variety of diverse styles of people, types, and classes; builds diverse networks; quick to find common ground; treats differences fairly and equitably; treats everyone as a preferred customer.
Thorough knowledge of this industry’s history, customers, and competitive environment; aptitude for recognizing opportunities where the company can provide clients further value, properly evaluating projects, strategy and design, and risks and advantages, to consistency improve operations for client satisfaction and company profit.
Ability to deliver clear, convincing, and well-organized presentations; project credibility and poise even in highly visible, adversarial situations; proactive, responsive, results oriented and resourceful; possessing the highest level of integrity and motivation.
Brings projects to completion; eliciting collaborations of interdepartmental team members.
Ability to multitask and manage multiple projects; flexible, and works well in a fast-paced and sometimes ambiguous environment.
Ability to write and present effectively; adjusting to fit the audience and the message; strongly gets a message across; proficiently communicates with a variety of health care providers and administrators; demonstrates an ability to project a professional and friendly image to internal and external clients.
Ability to manage strong working relationships within the company. Able to complete tasks and work cooperatively with others, proactively digs into issues with a concern for holistic stakeholder success.
Ability to respond and adapt to changing circumstances and to manage, solve problems and provide solutions in a climate of ambiguity; ability to flexible adjust hour to meet the needs of business stakeholders in a 365/24/7 environment; remaining punctual and dependable, and traveling as necessary.

Required Education and Experience:

Bachelor’s degree in Business Administration, Health Care, Project Management or other related discipline.
Seven years’ experience within healthcare.
Required previous experience managing pharmacy networks.
Desired two to four years' exposure to claims adjudication platforms, with Laker Software, PDMI, and Scriptcare experience preferred.
Previous work experience with pharmacy networks within a pharmacy benefit management company, or exposure to network management within long term care or hospice industries strongly preferred.
Previous experience delivering deliver clear and well-organized presentations, as well as proficient skills in MS Office Suite, including Word, Excel, and PowerPoint, used within past positions in order to execute all position needs

If this has piqued your interest, please send your resume to karen.newell@adeccona.com for immediate consideration.

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Reference number US_EN_2_027442_139846