Manager Pharmacy Actuarial & Contract Management

Independence Blue Cross; United States; Hybrid; USD 110,000 - 170,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

Independence Blue Cross seeks a Manager, Pharmacy Actuarial & Contract Management to drive pricing analytics and financial governance across PBM contracts. Reporting to the Director & Actuary, Rx Underwriting, you will lead actuarial staff and collaborate with Pharmacy, Finance, and Legal teams.

The role emphasizes analytical rigor, contract interpretation, and timely performance reporting to ensure pricing integrity and regulatory compliance.

Qualifications

• Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, or related field.
• 3-5 years actuarial, underwriting, or pharmacy financial analytics experience at a health plan or PBM.
• Experience working with complex vendor or PBM contracts and associated financial terms.
• Demonstrated experience leading projects and mentoring junior staff.
• Strong Excel and analytical modeling skills; experience with large or complex datasets.
• Ability to communicate complex financial and contractual concepts to non-technical stakeholders.

Responsibilities

• Participate in PBM market checks, vendor evaluations, and RFP financial assessments.
• Monitor PBM financial performance, including rebate economics, guarantees, and discount performance against contractual terms.
• Develop and maintain financial tracking tools of downstream contracts to ensure contractual terms are reflected in pricing analyses and performance reporting.
• Partner with Pharmacy, Finance, and Legal teams to interpret contract language and translate financial terms into operational assumptions.
• Support reconciliation and validation of rebate payments, guarantees, and other contractual settlements.
• Identify financial risks, variances, or potential compliance issues related to pharmacy contracts and elevate with clear analysis and recommendations.
• Assist the Director & Actuary with financial analyses supporting contract renewals, amendments, or renegotiations.
• Lead, coach, and develop actuarial and analytical staff; build relationships with Pharmacy, Finance, and Legal partners to ensure alignment.

Skills

Leadership

Communication

Analytical thinking

Mentoring

Education

Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, or related field

Tools

Excel

Job description

Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together, we will achieve our mission to enhance the health and well-being of the people and communities we serve.

Manager, Pharmacy Actuarial & Contract Management

supports the execution and ongoing management of pharmacy pricing analytics and the financial oversight of pharmacy-related contracts. Reporting to the Director & Actuary, Rx Underwriting, this role focuses on analytical rigor, contractual financial governance, and cross-functional execution while providing technical leadership to actuarial and analytical staff.

This position plays a critical role in ensuring pharmacy financial commitments are well understood, accurately tracked, and consistently reflected in pricing analyses and performance reporting.

Pharmacy Contract Management

• Participate in PBM market checks, vendor evaluations, and RFP financial assessments.
• Monitor PBM financial performance, including rebate economics, guarantees, and discount performance against contractual terms.
• Develop and maintain financial tracking tools of downstream contracts to ensure contractual terms are accurately reflected in pricing analyses and performance reporting.
• Partner with Pharmacy, Finance, and Legal teams to interpret contract language and translate financial terms into operational assumptions.
• Support reconciliation and validation of rebate payments, guarantees, and other contractual settlements.
• Identify financial risks, variances, or potential compliance issues related to pharmacy contracts and elevate with clear analysis and recommendations.
• Assist the Director & Actuary with financial analyses supporting contract renewals, amendments, or renegotiations.

Pharmacy Pricing & Analytics

• Prepare analytical support for pharmacy pricing studies, benefit change evaluations, and enhancements to standard pricing tools.
• Maintain awareness of pharmacy industry trends, benchmarks, and regulatory considerations to inform analytical assumptions and comparative assessments.
• Prepare or support pharmacy-related regulatory and compliance deliverables, ensuring accuracy and timeliness.

Team Leadership & Collaboration

• Manage, coach, and develop actuarial and analytical staff, emphasizing analytical rigor, documentation standards, and clear communication.
• Serve as a technical resource for pharmacy pricing analytics and contract-related financial analysis.
• Build strong working relationships with Pharmacy, Finance, and Legal partners to ensure alignment and transparency.
• Proactively surface insights, risks, and improvement opportunities to the Director & Actuary.

Qualifications

• Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, or related field.
• 3-5 years of actuarial, underwriting, or pharmacy financial analytics experience at a health plan or PBM.
• Experience working with complex vendor or PBM contracts and associated financial terms.
• Demonstrated experience leading projects and mentoring junior staff.
• Strong Excel and analytical modeling skills; experience with large or complex datasets.
• Ability to communicate complex financial and contractual concepts to non-technical stakeholders.

Additional Information

Independence has implemented a "Hybrid" model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the "Hybrid" model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.