Director, PBM & Payer Partnerships — Remote

Kaplan International; Town of Texas (WI); Hybrid; USD 150,000 - 180,000; Full time

Job summary

CSI Pharmacy is seeking a Director of Pharmacy Benefit Manager to lead the evaluation, negotiation, implementation, credentialing, and ongoing management of PBM agreements with health plans, payers, and managed care organizations. The role emphasizes securing financially advantageous terms while strengthening strategic relationships across the healthcare ecosystem.

The ideal candidate will supervise sales, account management, implementation, and operations for large national clients, including

Qualifications

• Minimum of five years of progressive experience in PBM operations, PBM sales, pharmacy contracting, or managed care contracting.
• Demonstrated success negotiating PBM, specialty pharmacy, and managed care agreements.
• Experience with payer credentialing and network participation.

Responsibilities

• Lead growth and strategic development of PBM business, including client acquisition, implementation, retention, and expansion initiatives.
• Negotiate, implement, and administer managed care across the assigned region.
• Maintain processes for contract terms, reimbursement methodologies, and payer updates to stakeholders.
• Manage all phases of the contract lifecycle from evaluation to termination.
• Develop relationships with medical and pharmacy benefit plans to secure favorable terms.
• Oversee payer credentialing and recredentialing activities to ensure network participation.

Skills

PBM operations

Contracting negotiations

Leadership

Multi-tasking

Relationship building

Education

Bachelor’s degree

Job description

CSI Pharmacy is seeking a Director of Pharmacy Benefit Manager to lead the evaluation, negotiation, implementation, credentialing, and ongoing management of PBM agreements with health plans, payers, and managed care organizations. The role emphasizes securing financially advantageous terms while strengthening strategic relationships across the healthcare ecosystem.

The ideal candidate will supervise sales, account management, implementation, and operations for large national clients, including