What you’ll do
In a few words…
Persuasive, strategic, and self-sufficient with negotiating skills that surpass any ambassador’s working on fragile international issues, that’s you. At least, that’s who we’d like you to be. As our Network Strategy Provider Relations Manager (Ooooh, another long title!), you will be responsible for managing the Company’s relations with all of the pharmacies in the Provider Network and act as a primary contact for Pharmacy Service Agreement Negotiations. (In other words, you’re the catalyst and oil that keeps the machine running smoothly without any major kinks.) You will work to ensure our Provider Network Agreements satisfy the needs of our clients as well as to ensure that our pharmacy partners are satisfied with the services we are obligated to provide to them. You will also be a leader of a small, but growing team. You’ll get to use all your skills here. Get ready!
The fundamentals for the job…
- Develop, execute and maintain pharmacy network strategies for US mainland and in Puerto Rico; including participants, network size, reimbursement drivers and terms (discounts, DIR, incentives), quality criteria, and other contracting elements
- Establish and maintain relationships with pharmacy chains and PSAOs, as well as national pharmacy organizations, i.e. NCPDP (We expect you to employ all your skills on this one.)
- Serve as primary point of contact for pharmacy contract and operational questions
- Negotiate pharmacy contracts (Why we requested those fantastical negotiating skills of yours.)
- Work with Legal teams on creating and revising pharmacy contracting documents (Fine print is important.)
- Use analytical tools and monitor network performance to ensure contract compliance and alignment with network objectives
- Align with Pharmacy Training teams on network education and other outreach initiatives
- Support network underwriting initiatives on both potential contract reimbursement changes, as well as bids for new business;
- Participate and support business development activities as requested (Expect them to be requested.)
- Provide support to Client Engagement and Audit teams in Network related items as directories, pharmacy education, member’s grievances, etc.
- Support Operations in the setup configuration and maintenance of pharmacy network requirements
- Direct the proper storage and retention of all pharmacy documentation (Data is our most valuable asset.)
- Strong understanding of NCPDP pharmacy and telecommunications data (During Arnold’s Terminator peak, he still had nothing on you.)
What you’re made of
The bold requirements…
- Bachelor’s Degree in Pharmacy, Business, Mathematics, or a related field, with 3+ years of professional experience, preferably within a PBM or health plan (In lieu of a degree, equivalent relevant work experience may be considered.)
- Previous underwriting or financial analysis and marketing experience with PBM or health plan would make us see rainbows hovering over your head with sparkles of fairy dust. In other words, we’d like that.
- Previous contract negotiation experience in PBM or a related industry
- Strong understanding of PBM client LOB: Commercial, Employer Groups, Health Plans, Medicare Part D, Medicaid, 340B, Discount Card (Stronger than The Hulk and Hercules put together.)
- Strong understanding of Pharmacy LOB: Retail, Long Term Care, Home Infusion, Mail Order, Specialty, Institutions (Refer to the parenthesis above.)
- Strong understanding of Pharmacy Relationships: Chains, PSAOs, Independents,
- This position requires Jedi Master computer proficiency. That means you can teach Bill Gates a thing or two about Microsoft Office (Word, Excel, PowerPoint) products, and your Internet surfing and research skills are Pipeline Master Champ levels.
- Your curious heart will love it here because you will have to maintain expert knowledge of the PBM industry, current/emerging pharmacy trend management strategies, and current/emerging Abarca product offerings.
- Your interpersonal skills should border on magical with an ability to work well with all levels of internal management and staff, as well as outside clients and vendors.
- Must be available for occasional travel to the main office for team events, industry conferences, client visits, corporate pharmacy meetings (Don’t worry, well get you masks, gloves, hand sanitizer, and disinfectant wipes.)
Nice to have…
- Experience in a Provider Relations, Chain Pharmacy, PSAO, Client Service, or a Relationship Management role would be like seeing a rainbow in a rainy morning.
- If you can communicate effectively (read, write, speak, meme, argue, Google stuff, and use proper Emoji code) in English and Spanish, it would make you exponentially more awesome.
- Experience in managing direct reports (Because the indirect ones are too indirect.)
That something extra we´d love to see…
- Communicator: Master of Words: It’s easy for you to find the right words that everyone can understand. Whether written or spoken, your communication flows like a crystalline river of poetic eloquence.
- Negotiator: Your communication and negotiation tactics are sharp. You’re the type of person that can talk their way out of anything. The FBI calls YOU when they need a negotiator. You have a certain aplomb that can take control of a situation and make decisions.
- Persuasive: Did you take hypnotism courses or something? Because you seem to sway things in your favor with ease. Your charm convinces anyone of anything. No need to insist, you’re hired!
- Self-sufficient: You work well on your own and whatever you don’t know, you figure out. You’re probably over-prepared for the apocalypse and have enough to back up the team as well. Your life motto: Bring it!
- Strategic: You’ve played every strategy game out there. Your mother claims you were born with a chessboard instead of a placenta attached to your umbilical cord and this could well be true. You’re always 3 steps ahead of the game, quickly spotting relevant patterns and issues
The above description is not intended to limit the scope of the job or to exclude other duties not mentioned. It is absolutely not a final set of specifications for the position. It’s simply meant to give readers an idea of what the role entails.
Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of gender, race/ethnicity, gender identity, sexual orientation, protected veteran status, disability, or other protected group status.