Vice President, Pharmacy Networks

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SmithRx

Site WebLinkedInTous les Emplois

51 - 200 employés

Fondée en 2018

💼 Conseil

🛡️ Assurance

🏥 Santé

💰 €20 000 000 Series B en 2022-03

Consulting • Insurance • Healthcare

SmithRx est un gestionnaire de prestations pharmaceutiques (PBM) transparent et en mode pass-through, opérant indépendamment des compagnies d'assurance et des pharmacies pour aligner ses incitations avec celles des employeurs auto-assurés et leurs membres. En s'appuyant sur la technologie moderne, SmithRx vise à réduire le coût et la complexité des prestations pharmaceutiques, garantissant la fourniture de médicaments efficaces et à faible coût. L'entreprise s'engage à transformer le paysage des prestations pharmaceutiques grâce à son modèle de tarification transparent et forfaitaire et à ses programmes d'économie de coûts innovants, qui connectent les membres aux médicaments les moins chers sans recourir à la tarification échelonnée, aux remises ou à d'autres tactiques. L'engagement de SmithRx envers la transparence et un service client supérieur se traduit par des économies significatives pour les employeurs et une expérience hautement satisfaisante pour ses membres.

Description

• Lead Network Strategy: Design and execute the overarching strategy for SmithRx’s national and custom pharmacy networks, ensuring alignment with our transparent business model and client needs. • Contract Negotiation: Lead high-level negotiations with major retail chains, PSAOs, specialty pharmacies, and mail-order partners to secure competitive reimbursement rates and favorable contract terms without relying on spread pricing. • Identify and develop innovative network programs (e.g., high-performance or narrow networks, direct-to-consumer delivery models) to drive down drug costs and improve member access. • Monitor and manage the ongoing performance of the pharmacy network against defined SLAs, ensuring adherence to contractual terms, quality standards, and pricing accuracy. • Direct the credentialing and re-credentialing processes, ensuring all network pharmacies comply with federal, state, and SmithRx regulatory standards. • Oversee the pharmacy audit team to manage network integrity, minimize Fraud, Waste, and Abuse (FWA), and execute audit recoveries effectively. • Implementation of needed policies and procedures to meet CMS oversight requirements. • Partner closely with Sales, Customer Success, Clinical Strategy, Pricing/Underwriting, and Product teams to ensure network capabilities are accurately represented in the market and successfully integrated into our technology platforms. • Collaborate with data and analytics teams to monitor network profitability, utilization trends, and cost models to proactively identify areas for financial optimization. • Build, mentor, and scale a high-performing team of network managers, contracting specialists, and analysts. Foster a culture of accountability, integrity, and courage.

🎯 Exigences

• 12+ years of progressive leadership experience in pharmacy network management, pharmacy contracting, or PBM operations. • Experience across lines of business: Commercial, Medicare, Medicaid, Exchange • Deep understanding of the PBM ecosystem, pharmacy reimbursement models (AWP, MAC, NADAC), and the operational differences between traditional and pass-through/transparent PBMs. • Proven track record of successfully negotiating complex, multi-million dollar contracts with major national pharmacy chains and PSAOs. • Demonstrated experience building, leading, and mentoring cross-functional and remote teams in a high-growth environment. • Strong financial and analytical skills with the ability to understand complex pricing models and translate data into actionable network strategies. • Bachelor’s degree in Business, Healthcare Administration, Finance, or a related field; PharmD or Master’s degree (MBA/MHA) is highly preferred.

🏖️ Avantages

• Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance and AD&D Insurance • Flexible Spending Benefits • 401(k) Retirement Savings Program • Short-term and long-term disability • Discretionary Paid Time Off • Paid Company Holidays • Wellness Benefits • Commuter Benefits • Paid Parental Leave benefits • Employee Assistance Program (EAP) • Well-stocked kitchen in office locations • Professional development and training opportunities