Strategic Pharmacy Contracting Lead

SmithRx; Oregon; Ibrido; USD 123.000 - 145.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical coverage

Pharmacy coverage

Dental

Vision

Life Insurance

401(k)

Discretionary PTO

Paid holidays

Wellness benefits

Commuter benefits

Parental leave

EAP

Descrizione del lavoro

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.

Competenze

• 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.

Mansioni

• 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.

Conoscenze

Contracting experience

Healthcare industry knowledge

Stakeholder management

Process ownership

Negotiation

Attention to detail

Formazione

Bachelor's degree in PBM/healthcare contracting

Experience in healthcare contracting

Strumenti

Excel/Google Sheets

Descrizione del lavoro

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.