Provider Contracting Director jobs in Kentucky

PharMerica

Responsible for strategic development, execution and support of Payor and PBM contracting for PharMerica Pharmacy business units.

Supports all Pharmacy contracting process and execution for PharMerica business units: LTC, Specialty Oncology and Home Infusion business units
• Works with Pharmacy Business leaders to manage and negotiate more favorable national and regional Pharmacy Network agreements to ensure company's objectives are met in a timely manner
• Develops and executes a dynamic and strategic PBM strategy to support Pharmacy annual plan and growth objectives
• Work with each business unit for financial underwriting and auditing of all new and existing contracts while working collaboratively with financial and operational leaders
• Directs and performs analysis necessary to ascertain PBM compliance with contractual obligations. This includes GER, BER, performance metrics, NADAC pricing schedules, etc.
• Significant understanding of the PBM landscape, national and regional, and reimbursement processes across Pharmacy business segments
• Analyzes applicable Pharmacy Network Agreements, associated documentation required, proposed fees, and financial terms of agreements
• Develop and oversee all components of contracting process, database management and communication to all business owners
• Participates and effectively manages cross-functional needs to efficiently support the flawless implementation of new contractual relationships and collaboration with all appropriate internal stakeholders
• Provides ongoing market and industry updates to the leadership team
• Excellent communication, executive presence, and interpersonal skills with demonstrated proficiency to advance business objectives cross-functionally
• Understanding and working knowledge of PBM program metrics, methodologies and recoupment processes
• Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards
• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily
• The requirements listed above are representative of the knowledge, skill, and/or ability needed.
• Each essential function is required, although reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

• Bachelor's degree in Business Administration, Life Sciences or related field required
• MBA desired
• Ten (10) or more years of related PBM or in-house Pharmacy PBM experience required
• Ten (10) or more years of health-plan contracting or provider experience required
• Fifteen (15) or more years of management experience in healthcare setting desired
• Strong analytical, communication, management and relationship skills required
• Advanced knowledge of Microsoft Office products (Excel, Word, Powerpoint) required
• Remote and/or On-Site as required
• 25% (Trade Shows, Association meetings, etc.) travel required