PBM Contract Manager

Independent Health; United States; Hybrid; USD 70,000 - 85,000; Full time

Job summary

Independent Health in Williamsville, NY, seeks a PBM Contract Manager to oversee client and vendor contracts for Pharmacy Benefit Dimensions. You will draft, review, negotiate and facilitate execution of agreements while conducting regulatory research and licensure management.

The role interfaces with Legal, business units, and outside counsel, managing tracking systems and reporting metrics to stakeholders. A hybrid on-site role is required at our Williamsville location.

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.

Responsibilities

• Research, define, capture, and understand the business needs to support review, negotiation and execution of registrations, licenses, and contracts for PBD.
• Research state and federal PBM regulations and monitor for changes or updates.
• Facilitate contracting process for RFPs, ASAs, amendments, vendor agreements, rebates, and licenses; draft, edit, negotiate and facilitate execution.
• Create and maintain tracking and reporting processes detailing performance metrics and compliance.

Skills

Analytical skills

Time management

Organizational skills

Independent work

Education

Bachelor’s degree

Paralegal studies

Tools

Microsoft Office

Windows

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.

Position Details

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.

Equal Opportunity / Aff…

As an Equal Opportunity / Aff… (truncated) . Current Associates must apply internally via the Job Hub. The Independent Health Family of Companies, headquartered in Buffalo, NY, serves nearly 400,000 members and provides innovative health care products and benefits designed to engage consumers in their health and well-being. Established in 1980, our comprehensive portfolio includes Pharmacy Benefit Dimensions, Reliance Rx, Nova Healthcare Administrators, Care for You and the Independent Health Foundation. Our culture sets us apart. Our core values drive who we are and the work we do. As a member of our family, you’re part of something special, in your work and in the community. We understand and appreciate that everyone has unique experiences, perspectives and identities which is why we pledge to create a safe space where all people and ideas are welcomed. We are here to continue learning and to generate important dialog. We are committed to doing what matters most - reaching out, working together, and caring for our community. A healthy community benefits everyone who lives in it. You too can be part of making difference in the lives of others, together we achieve so much more.

We are committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans. An applicant for employment in need of an accommodation to participate in the application and recruitment process should contact Human Resources at: [e-mail] or Human Resources, 511 Farber Lakes Drive, Williamsville, NY 14221.