PBM Contract Manager

Independent Health Association; Buffalo (NY); Hybrid; USD 70,000 - 85,000; Full time

Benefits offered by this job

Scorecard incentive

Full range of benefits

Generous paid time off

Job summary

Independent Health Association is seeking a PBM Contract Manager to oversee contracts for Pharmacy Benefit Dimensions (PBD) and ensure business needs are reflected in agreements.

The role drafts, reviews, negotiates and facilitates execution of new and existing contracts, while handling license and registration management and performance tracking. Hybrid role based in Williamsville with base compensation in the $70k–$85k range and comprehensive benefits.

Qualifications

• Bachelor's degree required; Paralegal Studies degree preferred; an additional four years of experience may substitute for degree.
• Five years of corporate/vendor contract management and negotiations, regulatory and/or compliance research and monitoring required.
• Experience with self-funded group health plans preferred.
• Strong analytical, problem solving, time management and organizational skills.
• Detail oriented with ability to manage multiple projects in a fast-paced environment.
• Advanced computer and Windows skills; ability to learn new software.

Responsibilities

• Research, define, capture, and understand business needs to support the review, negotiation and execution of contracts and registrations for PBD.
• Research state and federal PBM regulations and monitor for changes or updates.
• Responsible for obtaining and maintaining licensure or registrations across states; manage applications and renewals.
• Create, review, edit, negotiate and facilitate execution of all contracts and agreements; track and monitor contract terms and renewals.
• Communicate status and performance metrics to stakeholders; maintain policies and procedures for PBD.

Education

Bachelor's degree

Paralegal Studies degree (preferred)

Tools

Microsoft Office

Job description

FIND YOUR FUTURE

We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration.

Overview

The PBM Contract Manager will be responsible for the oversight and management of client, vendor and all other business contracts and agreements. The manager will capture, define, and understand the business needs of Pharmacy Benefit Dimensions (PBD) and will work to ensure those needs and interests are appropriately represented in contracts and other agreements. The manager will draft, review, negotiate and facilitate the execution of new and existing contacts and agreements and will have limited decision-making authority. The manager will be the liaison between PBD business units, Independent Health legal department and any outside legal counsel or vendors. Furthermore, the manager will be responsible for conducting state and federal regulatory research and monitoring and will prepare, file, and manage any business registration and licensures. The manager will be responsible for the creation and maintenance of tracking and monitoring processes, necessary policies and procedures, performance and reporting requirements and communicating overall metrics to key stakeholders.

Qualifications

• Bachelor's degree required. Paralegal Studies degree preferred. An additional four (4) years of experience will be considered in lieu of degree.
• Five (5) years of experience in corporate/vendor contract management and negotiations, regulatory and/or compliance research and monitoring required.
• Experience with self-funded group health plans preferred.
• Strong analytical, problem solving, time management and organizational skills.
• Detail oriented, while maintaining an awareness of overall goals.
• Ability to work independently and manage multiple projects in a fast-paced fluid environment.
• Advanced computer and Windows skills required. Experience with Microsoft Office applications, and ability to learn new software applications.
• PBD values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication and Caring.

Essential Accountabilities

Research and Monitoring:

• Research, define, capture, and understand the business needs to support the review, negotiation and execution of all registrations, licenses, agreements and contracts for PBD.
• Research state and federal PBM regulations and business requirements and monitor and track for any changes or updates.

License and Registration Management:

• Research application and regulatory requirements for PBMs to obtain and maintain licensure or business registration in various states in which PBD wishes to conduct business.
• Complete and facilitate all necessary application and documentation requirements for the timely submission of all initial and renewal license and/or registration applications.
• Develop and maintain tracking and monitoring processes to ensure compliance with business operations, application, and renewal requirements.

Contract Management:

• Facilitate and oversee the contracting process for all documents such as: requests for proposals (RFPs), Administrative Service Agreements (ASAs), Amendments, vendor agreements, rebate contracts, pharmacy and network contacts and software licenses.
• Create draft documents, as well as review, edit, negotiate and facilitate execution of all agreements and contracts.
• Work with PBD business units to research, capture and understand the business needs to support the review and negotiation of all agreements and contracts for PBD to conduct business.
• Develop, implement and maintain tracking and monitoring processes to ensure compliance with contract terms and conditions.
• Facilitate the timely review and renewal of all contacts as necessary.

Documentation and Communications:

• Create and maintain tracking and reporting processes to detail performance metrics of the processes and duties.
• Create and maintain policies, procedures, and other documentation specific to PBD to appropriately support the processes and duties.
• Appropriately communicate needs, status, and overall performance metrics to all key stakeholders.

This is a hybrid position with onsite attendance required at our Williamsville location. Immigration or work visa sponsorship will not be provided for this position Hiring Compensation Range: $70,000 - $85,000 annually

Compensation may vary based on factors including but not limited to skills, education, location and experience.

In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future.

As an Equal Opportunity / Aff­irmati­ve Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant's race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law.