Ohio Pharmacy Network Lead — Contracts & Relations

Gainwell Technologies; Kentucky; On-site; USD 114,000 - 163,000; Full time

Benefits offered by this job

Flexible vacation policy

401(k) match

Health benefits

Educational assistance

Leadership development academies

Technical development academies

Job summary

Gainwell Technologies seeks a Provider Contract Lead to support Ohio Medicaid pharmacy network management. You will lead outreach, contract execution, and ongoing network maintenance, coordinating with internal teams to ensure access, accuracy, and compliance.

The role requires 5+ years in PBM or related fields, 2+ years of leadership, strong data reporting skills, and ability to work Eastern Time hours. This is a full-time, on-site position in Ohio with competitive pay and benefits.

Qualifications

• 5+ years of experience in PBM, pharmacy operations, drug claims processing, pharmacy network management, or contracting
• 2+ years of leadership or supervisory experience
• Pharmacy network management experience within Ohio Medicaid or PBM environments strongly preferred
• Strong knowledge of pharmacy claims adjudication, Medicaid programs, PBM operations, and pharmacy network maintenance
• Experience with client communications, client-facing discussions, relationship management, and cross-functional partnership
• Experience with operational reporting, KPIs, audits, process improvement, data analysis, and Excel
• Ability to work with urgency, manage multiple priorities, communicate clearly in a fast-paced, time-sensitive environment, and support Eastern Time business hours

Responsibilities

• Manage relationships with pharmacies in Ohio’s network and support pharmacy outreach, contract execution, and ongoing network maintenance
• Serve as a liaison between pharmacies and internal Gainwell teams, including finance, claims, operations, compliance, and client-facing partners
• Monitor pharmacy network adequacy, access-to-care requirements, and network-to-pharmacy issues, including member access and travel considerations
• Maintain accurate provider directory information, pharmacy network data, policies, procedures, and out-of-network processes
• Support Ohio claims-related communications by ensuring pharmacy network information is accurate, timely, and distributed to pharmacy staff
• Run operational, KPI, client, monthly, quarterly, and pharmacy network management reports to support performance monitoring and decision-making
• Support third-party audits, including CMS, ISCA, and Ohio Department of Medicaid audits
• Identify risks, resolve inquiries, and support process improvement, new service needs, and RFP-related activities

Job description

Gainwell Technologies seeks a Provider Contract Lead to support Ohio Medicaid pharmacy network management. You will lead outreach, contract execution, and ongoing network maintenance, coordinating with internal teams to ensure access, accuracy, and compliance.

The role requires 5+ years in PBM or related fields, 2+ years of leadership, strong data reporting skills, and ability to work Eastern Time hours. This is a full-time, on-site position in Ohio with competitive pay and benefits.