Director – Networks and Underwriting

Jobtailor; Deutschland; Remote; EUR 90.000 - 150.000; Vollzeit

Zusammenfassung

TrueScripts is seeking a Senior Lead to drive pharmacy network strategy, underwriting, and financial modeling for clients and renewals. You will establish network structures, monitor performance, and shape pricing and reimbursements across populations and markets.

The role requires strong analytical and communication skills, with remote work flexibility and occasional travel to the Washington, Indiana office.

Qualifikationen

• Bachelor’s degree in Accounting, Finance, Business, Healthcare Administration, Compliance, or related field.
• 7+ years of progressive PBM, pharmacy benefits, healthcare, underwriting, network management, pricing, or related areas.
• Demonstrated experience with PBM financial modeling and underwriting.
• Strong understanding of pharmacy network economics and reimbursement methodologies.
• Experience with PBM pricing, guarantees, rebates, discounts, and financial commitments.
• Excellent communication, negotiation, and presentation skills.
• Primarily remote position with occasional travel to the TrueScripts office in Washington, Indiana.

Aufgaben

• Lead TrueScripts’ pharmacy network strategy, performance management, contracting strategy, and network optimization
• Evaluate network options and determine appropriate network structures for client populations and market segments
• Establish network performance objectives and monitor network economics, access, competitiveness, and client impact
• Analyze pharmacy reimbursement trends, market dynamics, competitive positioning, and pharmacy economics
• Oversee the development and enhancement of PBM underwriting methodology
• Oversee financial modeling for new business, renewals, and existing client opportunities
• Establish assumptions for pharmacy utilization, drug mix, reimbursement, discounts, rebates, dispensing fees, trends, and other financial variables
• Evaluate financial risk, margin opportunity, pricing recommendations, and underwriting assumptions
• Oversee contractual guarantees related to network discounts, ingredient cost, rebates, trend, pricing, and other PBM commitments
• Monitor guarantee performance and recommend corrective actions for variances
• Support new business and renewal opportunities, RFPs, proposals, negotiations, and deal structure decisions
• Provide strategic direction on pharmacy reimbursement, contracting approaches, acquisition costs, MAC pricing, ingredient costs, and dispensing fees
• Develop dashboards, reporting, KPIs, executive-level analyses, and actionable recommendations
• Partner cross-functionally with Finance, Sales, Client Services, Clinical, Operations, Data & Analytics, and Executive Leadership
• Lead, develop, and coach Network and Underwriting team members
• Establish goals, accountability, succession plans, standardized processes, and documentation

Kenntnisse

PBM Financial Modeling

Pharmacy Network Economics

Underwriting Methodology

Cross-Functional Leadership

Analytical Skills

Communication Skills

Negotiation Skills

Presentation Skills

Coaching Skills

Influencing Skills

Ausbildung

Bachelor’s degree in Accounting, Finance, Business, Healthcare Administration, Compliance, or related degree

Jobbeschreibung

• Lead TrueScripts’ pharmacy network strategy, performance management, contracting strategy, and network optimization
• Evaluate network options and determine appropriate network structures for client populations and market segments
• Establish network performance objectives and monitor network economics, access, competitiveness, and client impact
• Analyze pharmacy reimbursement trends, market dynamics, competitive positioning, and pharmacy economics
• Oversee the development and enhancement of PBM underwriting methodology
• Oversee financial modeling for new business, renewals, and existing client opportunities
• Establish assumptions for pharmacy utilization, drug mix, reimbursement, discounts, rebates, dispensing fees, trends, and other financial variables
• Evaluate financial risk, margin opportunity, pricing recommendations, and underwriting assumptions
• Oversee contractual guarantees related to network discounts, ingredient cost, rebates, trend, pricing, and other PBM commitments
• Monitor guarantee performance and recommend corrective actions for variances
• Support new business and renewal opportunities, RFPs, proposals, negotiations, and deal structure decisions
• Provide strategic direction on pharmacy reimbursement, contracting approaches, acquisition costs, MAC pricing, ingredient costs, and dispensing fees
• Develop dashboards, reporting, KPIs, executive-level analyses, and actionable recommendations
• Partner cross-functionally with Finance, Sales, Client Services, Clinical, Operations, Data & Analytics, and Executive Leadership
• Lead, develop, and coach Network and Underwriting team members
• Establish goals, accountability, succession plans, standardized processes, and documentation

Requirements

• Bachelor’s degree in Accounting, Finance, Business, Healthcare Administration, Compliance, or related degree in Business, Finance, Economics, Healthcare Administration, Pharmacy, or related field
• 7+ years of progressive experience in PBM, pharmacy benefits, healthcare, underwriting, network management, pricing, or related areas
• Demonstrated experience with PBM financial modeling and underwriting
• Strong understanding of pharmacy network economics and reimbursement methodologies
• Experience with PBM pricing, guarantees, rebates, discounts, and financial commitments
• Strong analytical and financial modeling skills
• Demonstrated experience leading cross-functional initiatives and influencing executive-level decisions
• Strong understanding of pharmacy claims and utilization data
• Excellent communication, negotiation, and presentation skills
• Primarily remote position with occasional travel to the TrueScripts office in Washington, Indiana
• Less than 10% travel required

Core Competencies

Demonstrates expertise in pharmacy network strategy, financial modeling, and reimbursement methodologies, with a strong focus on performance management and cross-functional collaboration. Proven ability to lead teams, influence executive decisions, and develop actionable insights through data analysis.

Highest-signal resume keywords

• PBM Financial Modeling
• Pharmacy Network Economics
• Underwriting Methodology
• Cross-Functional Leadership
• Analytical Skills

Hard Skills

• Financial Modeling
• Pharmacy Reimbursement
• Network Optimization
• Pricing Strategies
• Contracting Strategies
• Data Analysis
• KPI Development
• Pharmacy Claims Analysis
• Utilization Data Analysis
• Market Dynamics Evaluation

Soft Skills

• Communication Skills
• Negotiation Skills
• Presentation Skills
• Coaching Skills
• Influencing Skills

Industry Keywords

• Pharmacy Benefits Management
• Healthcare Administration
• Network Management
• Rebates
• Discounts
• Financial Commitments
• Client Services
• Executive Leadership
• RFPs
• Business Development