Network Management Consultant - Remote

Network Management Consultant - RemoteAt Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve.Looking for a purpose-driven career? Come build the future of pharmacy with us.The Network Management Consultant is responsible for development, performance and management of Prime's retail, mail, specialty, and quality-based networks aligning with Prime's Supply Chain Cost of Goods Sold (COGS) and network management strategies.This includes development of network contracts, participation requirements, analysis of pharmacies, and ensuring contract and regulatory compliance.This position is accountable for creation and management of specialty fee schedules to ensure competitiveness and serves as the liaison between Prime's Network Management and Specialty teams.Responsibilities :Negotiate market competitive high-profile and / or complex pharmacy agreements across all channels including retail, mail, specialty and quality based and lines of business aligning with Supply Chain COGS strategiesLead and manage specialty fee schedule development process and ensure fee schedule revisions align with Supply Chains COGS strategies for specialty drug managementLead and implement network initiatives by facilitating and performing network analyses, contracting activities and fee schedule development aligning with strategy, priorities and projects goalsPartner with Prime's reporting and analytics teams to develop network vendor loading rules inclusive of approved preferred and specialty pharmacies; maintain key compliance criteria and implement quarterly reporting processes for all contracted network specialty pharmaciesAnalyze network specialty pharmacy quarterly reports to ensure compliance with reporting and participation requirements; collaborate with Specialty Clinical Program Directors to identify potential performance gaps; work with internal and external partners to develop and manage corrective action plansResponsible for effectively managing the pharmacy contract from negotiation of all terms, ensuring Prime and Pharmacy compliance and document retention aligning with Prime's Record Information Management (RIM) policiesWork closely with Prime's legal team to update contract documents including agreements and applications for utilization in contracting / re-contracting activities based on new network participation requirementsOther duties as assignedMinimum Qualifications :Bachelor's degree in business or related area of study, or equivalent combination of education and / or relevant work experience; HS diploma or GED is required8 years of Network Management experience within Pharmacy Benefit Management (PBM), healthcare or other highly regulated industry; including 5 years of managed care experience in medical or pharmacy network contracting.Must be eligible to work in the United States without the need for work visa or residency sponsorshipAdditional Qualifications :Excellent verbal and written presentation skillsDemonstrated understanding of network reporting and analysis for specialty pharmacyDemonstrated ability to establish trust and credibility; form working relationships with all levels of an organizationDemonstrated ability to work independently and on highly complex contract language and agreements; strong attention to detailEnhanced organizational skills with the ability to work on multiple projects simultaneouslyDemonstrated ability to problem solve and interpret complex data; ability to analyze network information and synthesize it into meaningful information for a variety of audiencesAbility to work with confidential data and maintain privacyPreferred Qualifications :Master's degree in business, healthcare or related area of studyDemonstrated understanding of retail and specialty network fee schedule management2 years of experience in specialty contractingPBM and Healthcare experienceEvery employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship.In addition, Prime retains the right to change or assign other duties to this job.Potential pay for this position ranges from $94,000.00 - $160,000.00 based on experience and skills.Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer.We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.Prime Therapeutics LLC is a Tobacco-Free Workplace employer.Positions will be posted for a minimum of five consecutive workdays.. Experience: 5 years required