At PDMI, we're seeking a talented Pharmacy Network Contract Manager to join our team! In this role, you'll play a crucial part in managing our pharmacy network contracting functions, developing and maintaining relationships with pharmacy service providers, including performing or assisting with negotiating service contracts, and resolving issues and disputes.
Since 1984, PDMI has provided pharmacy data processing and other flexible, scalable solutions to help our clients meet their business objectives. We offer transparent, pass-through pharmacy processing and other services for private label Pharmacy Benefit Managers (PBMs), vertically integrated health plans and hospital systems. In addition to Pharmacy Benefit Administrative Services, we offer 340B Administration, Hospice and Long-Term Care Services.
Why Join Us:
- Best Employer: PDMI was voted a Best Employer in Ohio for the 3rd consecutive year in 2023!
- Meaningful Work: Contribute to improving healthcare quality and efficiency.
- Collaborative Environment: Work with passionate professionals who share your drive.
- Exciting Challenges: Every day brings new opportunities to excel.
- Flexible Work: Fully remote opportunity (from approved locations within the U.S.!) with a company that cares.
Responsibilities:
- Negotiating contracts with pharmacy network providers
- Serving as the subject matter expert on standard pharmacy services agreement language
- Maintaining a deep understanding of pharmacy provider services and network demographics
- Managing the implementation of contract language and reimbursement terms
- Providing support in network credentialing and enrollment processes
- Tracking and maintaining pharmacy network rate information
- Resolving claims issues with pharmacy providers
- Interpreting contract language to ensure compliance
Requirements:
- A Bachelor's degree in a related field or proven industry experience
- Minimum of three years of experience in negotiating contracts for reimbursement within the industry
- Contract, legal, and compliance experience
- Strong pharmacy claim acumen
- Excellent negotiation, communication, and organizational skills
- Proficiency in Microsoft Office and Adobe