Network Management Consultant - Remote

Network Management Consultant - Remote

At 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 strategies
• Lead and manage specialty fee schedule development process and ensure fee schedule revisions align with Supply Chains COGS strategies for specialty drug management
• Lead and implement network initiatives by facilitating and performing network analyses, contracting activities and fee schedule development aligning with strategy, priorities and projects goals
• Partner 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 pharmacies
• Analyze 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 plans
• Responsible 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) policies
• Work 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 requirements
• Other duties as assigned

Minimum Qualifications :

Additional Qualifications :

Preferred Qualifications :

Every 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.