Pharmacy Network Contracting Manager

SmithRx; Oregon; Hybrid; USD 123,000 - 145,000; Full time

Benefits offered by this job

Medical coverage

Pharmacy coverage

Dental

Vision

Life Insurance

401(k)

Discretionary PTO

Paid holidays

Wellness benefits

Commuter benefits

Parental leave

EAP

Job summary

SmithRx in the United States is seeking a Pharmacy Network Contracting Manager to own the end-to-end contracting lifecycle. You will lead day-to-day contracting operations, manage the pipeline, and ensure accurate reimbursement terms and dates across the claims system, partnering with Legal and Provider Relations.

You will drive rate loading, risk assessment, and post-load validation, while building playbooks, governance, and reporting to improve throughput and provider clarity.

Qualifications

• Bachelor's degree or equivalent in PBM, managed care, healthcare contracting, network operations, or provider relations.
• 8+ years of experience in pharmacy/provider contracting, PBM network operations, or healthcare contract administration.
• 2+ years as a SME, process owner, or managing high-volume contracting workflows.
• Excellent written and verbal communication with ability to document complex issues and decisions.

Responsibilities

• Lead day-to-day contracting operations and mentor team members.
• Own and optimize the contracting pipeline from intake to delivery timelines.
• Govern the end-to-end lifecycle across new agreements, amendments, renewals, notices and terminations.
• Lead complex negotiations with Legal and internal stakeholders to mitigate risks.
• Ensure reimbursement exhibits, fee schedules, and effective dates are accurate.
• Drive rate loading and network configuration within the claims system and ensure timely implementation.
• Architect controls and QA for rate setup and mapping requirements.
• Monitor backlog and elevate risks affecting go-lives or claim outcomes.
• Own post-load validation, root-cause analysis, and timely corrections.
• Collaborate with Provider Relations on timelines and provider communications.
• Escalate contracting- or configuration-related provider issues and drive resolution.
• Create and maintain contracting playbooks, SOPs, templates, and standard responses.
• Govern contracting documentation and version control.
• Provide routine data reports on volume, cycle time, backlog, and trends.
• Build a comprehensive contracting knowledge base for internal enablement.

Skills

Contracting experience

Healthcare industry knowledge

Stakeholder management

Process ownership

Negotiation

Attention to detail

Education

Bachelor's degree in PBM/healthcare contracting

Experience in healthcare contracting

Tools

Excel/Google Sheets

Job description

Who We Are

SmithRx is a rapidly growing, venture-backed Health-Tech company. Our mission is to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector by building a next-generation drug acquisition platform driven by cutting edge technology, innovative cost saving tools, and best-in-class customer service. With hundreds of thousands of members onboarded since 2016, SmithRx has a solution that is resonating with clients all across the country.

We pride ourselves for our mission-driven and collaborative culture that inspires our employees to do their best work. We believe that the U.S healthcare system is in need of transformation, and we come to work each day dedicated to making that change a reality. At our core, we are guided by our company values:

• Integrity: Our purpose guides our actions and gives us confidence in the path ahead. With unwavering honesty and dependability, we embrace the pressure of challenging the old and exemplify ethical leadership to create the new.
• Courage: We face continuous challenges with grit and resilience. We embrace the discomfort of the unknown by balancing autonomy with empathy, and ownership with vulnerability. We boldly challenge the status quo to keep moving forward - always.
• Together: The success of SmithRx reflects the strength of our partnerships and the commitment of our team. Our shared values bind us together and make us one. When one falls, we all fall; when one rises, we all rise.

Job Summary

The Pharmacy Network Contracting Manager supports the Director of Contracting by serving as the principal process owner for day-to-day pharmacy network contracting operations while partnering closely with Provider Relations to support a strong provider experience at scale. Operating as a highly autonomous individual contributor, this role owns the contracting pipeline and governance, and ensures agreements are negotiated, executed, and accurately configured in SmithRx's claims adjudication system—including reimbursement rates, network participation, and effective dates. The key objective is to improve contracting throughput, consistency, configuration accuracy, and audit readiness while reducing provider friction through clear coordination, communication, and issue resolution.

What you will do

• Lead day-to-day pharmacy contracting operations, serving as the principal subject matter expert and providing mentorship and process guidance to team members.
• Own and optimize the contracting pipeline (intake, prioritization, aging, execution timelines, and deliverables).
• Govern the end-to-end contract lifecycle across new agreements, amendments, renewals, notices, and terminations, including milestone and deadline tracking.
• Lead complex contract negotiation workflows and redline reviews partnering directly with Legal and internal stakeholders to mitigate systemic risks.
• Ensure all reimbursement exhibits, fee schedules, and effective dates are meticulously accurate, approved, and implementation-ready.
• Drive rate loading and network configuration in the claims adjudication system to ensure executed terms are implemented accurately and on time.
• Architect and enforce controls and QA frameworks for rate setup (effective dates, plan/network mapping, reimbursement logic, and exception handling).
• Monitor and manage the rate load/configuration backlog, proactively prioritize urgent builds, mitigate and elevate risks that could impact go-lives or claim outcomes.
• Own post-load validation checkpoints (test claims/spot checks, variance reviews, and issue triage) lead root-cause analysis and ensure corrections are completed.
• Partner strategically with Provider Relations to align contracting timelines, onboarding requirements, and provider-facing communications during contracting and execution.
• Act as the definitive escalation point for contracting- or configuration-related provider escalations; document root causes and drive resolution through and across the appropriate teams.
• Author, govern, and maintain contracting playbooks, SOPs, templates, clause guidance, and standard responses to improve speed, consistency, and provider clarity.
• Drive contract repository and configuration documentation governance (version control, naming standards, executed package completeness, approvals, and change history).
• Leverage data to provide routine reporting on contracting/configuration volume, cycle time, backlog, and issue trends; lead continuous process improvement initiatives to scale operations.
• Architect and maintain a comprehensive contracting knowledge base (FAQs, standard workflows, and escalation paths) to drive internal enablement and elevate the provider experience.

What you will bring to SmithRx

• Bachelor's degree or equivalent relevant experience in PBM, managed care, healthcare contracting, network operations, or provider relations.
• 8+ years of experience in pharmacy/provider contracting, PBM network operations, or healthcare contract administration.
• 2+ years of experience serving as a principal subject matter expert, process owner and/or managing high-volume contracting workflows.
• Exceptional ability to interpret complex contract language, lead redline negotiations, and strategically identify business, operational, and compliance risks.
• Deep technical understanding of claims adjudication and pharmacy reimbursement configuration (how executed terms translate into system setup).
• Proven experience architecting or overseeing rate loading and configuration accuracy, including effective-date controls and mapping requirements.
• Demonstrated ability to work provider-facing issues through resolution while balancing contracting standards and operational feasibility.
• Advanced cross-functional stakeholder management skills across Provider Relations, Legal, Pricing, Credentialing, Operations, Compliance, and Finance.
• Excellent written and verbal communication skills with the ability to clearly document complex issues, decisions, and next steps.
• Meticulous attention to detail, and the ability to autonomously manage competing priorities and deadlines.
• Advanced proficiency with Excel/Google Sheets and contract tracking/document management practices.
• PBM pharmacy network experience (retail, PSAO/independents, specialty) preferred.

What SmithRx Offers You

• Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance and AD&D Insurance
• Flexible Spending Benefits
• 401(k) Retirement Savings Program
• Short-term and long-term disability
• Discretionary Paid Time Off
• Paid Company Holidays
• Wellness Benefits
• Commuter Benefits
• Paid Parental Leave benefits
• Employee Assistance Program (EAP)
• Well-stocked kitchen in office locations
• Professional development and training opportunities

Zone A includes the following locations

• San Francisco Bay Area - California
• Metro New York City - Connecticut, New Jersey, New York and Pennsylvania

Zone A Pay Range

$147,000-$174,000 USD

Zone B includes the following locations

• California - outside of San Francisco Bay Area
• Metro Denver / Boulder - Colorado
• Metro District of Columbia - District of Columbia, Maryland, Virginia and West Virginia
• Metro Boston / Cambridge - Massachusetts and New Hampshire
• Metro Austin - Texas
• Metro Seattle - Washington

Zone B Pay Range

$135,600-$159,500 USD

Zone C includes all other locations not listed above, including

• Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Wisconsin, Wyoming
• Non metro Colorado, Connecticut, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Texas, Virginia, Washington, and West Virginia

Zone C Pay Range

$123,300-$145,000 USD

Compensation & Benefits

• Base Salary: The range listed above reflects our standard pay scale and actual pay will vary based on work location, job level, job-related knowledge, skills, and experience.
• Total Rewards: In addition to base pay, this role may be eligible for bonuses, commissions, or equity. SmithRx offers a variety of benefits to help you live well, including: time off programs, medical, dental, vision, mental health support, paid parental leave, life and disability insurance and 401(k).

Individual offers are tailored to your geography, experience, skills, and education. Your recruiter can share more specific details during the hiring process. In the meantime, feel free to explore our comprehensive benefits here.