Remote PBM & Payer Strategy Director

CSI Pharmacy, LLC; United States; Remote; USD 150,000 - 180,000; Full time

Job summary

CSI Pharmacy (CSI) seeks a Director of Pharmacy Benefit Manager to lead PBM contract strategy, credentialing, and ongoing management with national payers.

You will strengthen payer relationships, optimize reimbursement terms, and coordinate with sales, operations, and compliance to ensure timely contract execution.

This remote role supports CST/EST regions, requires 25–30% travel, and offers a compensation range of $150,000–$180,000 per year (DOE).

Qualifications

• Knowledge of PBM operations, managed care contracting, and Medicare/Medicaid reimbursement.
• Strong negotiation, analytical and communication skills.
• Ability to develop and maintain professional relationships with payers and providers.

Responsibilities

• Lead growth and strategic development of the PBM business across regions.
• Negotiate and administer managed care contracts and credentialing.
• Develop processes for timely dissemination of contract terms and payer updates.
• Oversee full contract lifecycle: evaluation, negotiation, approval, implementation, renewal, amendment, termination.
• Analyze contract performance and reimbursement trends for revenue optimization.
• Ensure understanding of payer reimbursement methodologies and provider payment structures.
• Serve as primary contact for payer relations and contract performance management.
• Collaborate with leadership and cross-functional teams to ensure successful contract implementation and compliance.
• Develop relationships with payers to secure favorable rates and language.
• Oversee payer credentialing and recredentialing and respond to payer issues.
• Monitor payer compliance with contract terms and address issues as they arise.
• Identify market opportunities and support growth through payer engagement.
• Communicate payer trends and regulatory developments to leadership.
• Represent the company professionally in interactions with payers and clients.
• Maintain relationships across departments.
• Adhere to company policies, compliance, and regulatory standards.

Skills

PBM operations

Contract negotiation

Payer relations

Leadership

Strategic development

Education

Bachelor’s Degree or equivalent experience

Job description

CSI Pharmacy (CSI) seeks a Director of Pharmacy Benefit Manager to lead PBM contract strategy, credentialing, and ongoing management with national payers.

You will strengthen payer relationships, optimize reimbursement terms, and coordinate with sales, operations, and compliance to ensure timely contract execution.

This remote role supports CST/EST regions, requires 25–30% travel, and offers a compensation range of $150,000–$180,000 per year (DOE).