Senior Pharmacy Network Contracting Lead

SmithRx; United States; Remote; USD 147,000 - 174,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

AD&D Insurance

401(k) Retirement Savings Program

PTO

Job summary

SmithRx is seeking a Pharmacy Network Contracting Manager to lead day-to-day contracting operations, own the contracting pipeline, and govern the end-to-end lifecycle. You will partner with Legal and Provider Relations to optimize terms, ensure accuracy of reimbursement configurations, and drive rate loading in the claims system.

You will also develop playbooks, maintain documentation, and provide routine reporting on volume, cycle time, backlog, and risk trends to scale contracting operations.

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 SME, process owner, or managing high-volume contracting workflows.
• Ability to interpret complex contract language and lead redline negotiations.
• Deep technical understanding of claims adjudication and pharmacy reimbursement configuration.
• Experience architecting rate loading and configuration accuracy, including effective-date controls.
• Strong cross-functional stakeholder management across.Provider Relations, Legal, Pricing, Credentialing, Operations, Compliance, and Finance.
• Excellent written and verbal communication skills.

Responsibilities

• Lead day-to-day pharmacy contracting operations and mentor team members.
• Own and optimize the contracting pipeline from intake to delivery.
• Govern end-to-end contract lifecycle including amendments, renewals, notices and terminations.
• Lead complex contract negotiation workflows with Legal and internal stakeholders.
• Ensure reimbursement exhibits, fee schedules, and effective dates are accurate and implementation-ready.
• Drive rate loading and network configuration in the claims adjudication system.
• Architect and enforce QA controls for rate setup and mapping.
• Monitor backlog and mitigate risks to go-lives and claim outcomes.
• Author and maintain contracting playbooks, SOPs, templates, and responses.

Education

Bachelor's degree or equivalent

Tools

Contract management system

Excel/Sheets

Job description

SmithRx is seeking a Pharmacy Network Contracting Manager to lead day-to-day contracting operations, own the contracting pipeline, and govern the end-to-end lifecycle. You will partner with Legal and Provider Relations to optimize terms, ensure accuracy of reimbursement configurations, and drive rate loading in the claims system.

You will also develop playbooks, maintain documentation, and provide routine reporting on volume, cycle time, backlog, and risk trends to scale contracting operations.