Senior Manager, Pharmacy Pricing
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Job Description
Manager, Pharmacy Pricing leading a team to manage client pricing and financial analytics. Overseeing strategic direction and resolving discrepancies while supporting organizational goals.
Responsibilities:
- In this multi-disciplinary, cross functional role, the Manager, Pharmacy Pricing will report to the Director, Pharmacy Pricing & Analytics.
- The Manager, Pharmacy Pricing is a leader and key contributor to the financial reporting and client retention process.
- This role is responsible for leading the team that executes, updates, and provides strategic direction for existing client pricing.
- The team also assists with resolving client issues involving performance discrepancies, claims issues, and reporting.
- The successful Pharmacy Pricing Senior Manager will be able to manage multiple projects at once, lead a team, and champion our mission and culture.
- Essential Job Responsibilities Include: End to end management of existing client pricing, analytics, and reporting.
- Leadership of the pricing team, consisting of up to 10 direct reports.
- This includes providing training, day-to-day direction, strategic vision, and mentoring/growth to all team members.
- Ability to lead with influence across internal stakeholders to foster collaborative and efficient work products.
- Review for accuracy and finalize all current account pricing comparisons for submission.
- Provide strategic insight and support the AM and Deal Governance teams for At-Risk accounts.
- Manage and support the current account claim and data requests.
- Respond to competing PBM offers to show RxBenefits pricing value and defend at-risk accounts.
- Prepare quarterly reports associated with financial performance.
- Lead the production and delivery of all current account annual renewal reporting (Pricing refresh & comparison).
- Support the PBM Pricing Analysts with validating new pricing products in Salesforce.
- Perform key audits for new pricing enrollments and monthly contract guarantee performance.
- Validate and test updates in SAS associated with pricing and exclusions to maintain reporting accuracy.
- Research and analyze discrepancies between projected rebates and payments received.
- Act as point of contact for the PBM partners to resolve pricing discrepancies.
- Model pricing improvements related to PBM negotiations for improved renewal pricing and terms.
- Identify gaps and opportunities in the current processes for enhanced visibility and efficiency.
- Act as a cross-functional representative throughout the organization to provide strategic insight and support organization goals and initiatives.
- Lead the development and application of advanced analytics techniques driving operational efficiencies, providing consultative support, enabling informed decision making, and producing KPIs for senior leadership.
- Analyze data to uncover potential issues / provide financial impacts.
- Provide custom analytics/modeling for ad-hoc projects.
Requirements:
- 5+ years of actuarial or underwriting experience required
- 5+ years of PBM pricing or RFP experience required, large PBM experience desired
- 5+ years of leadership experience, preferably in PBM or Health Plan setting
- High degree of emotional intelligence
- Expert cross functional interpersonal, communication, and collaborative management skills
- Advanced knowledge of Microsoft Office, Advanced Excel experience required
- Proficient knowledge of SAS, SQL, Snowflake, or other data programming languages
- Strong team building, relationship management, and project management skills
- Independent/self-starting nature
- Process and procedure oriented
- Highly competent problem solver
Benefits:
- Remote first work environment
- Choice of a HDHP or PPO Medical plan, we pay 100% of the premium for the HDHP for you and your eligible family members
- Dental, Vision, Short- and Long-Term Disability, and Group Life Insurance that we also pay 100% of premiums (for your family too on Dental and Vision)
- Additional buy-up options for Short- and Long-Term Disability and Life Insurance
- 401(k) with an employer match up to 3.5% available after 60 days
- Community Service Day to give back and support what you love in your community
- 10 company holidays including MLK Day, Juneteenth, and the day after Thanksgiving plus a floating holiday to use as you like
- Reimbursements for high-speed internet, we’ll send you a computer and monitors to help you do your best work
- Tuition Reimbursement for accredited degree programs
- Paid New Parent Leave that can be used for adoption or birth
- Pet insurance to protect your furbabies
- A robust mental health benefit and EAP service through Spring Health to support you when you need it most
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