Vice President, Pharmacy Networks

This is a fully remote position, open to applicants in United States.

📋 Description

• Lead Network Strategy: Develop and implement the comprehensive strategy for SmithRx’s national and customized pharmacy networks, ensuring it aligns with our transparent business model and client requirements.

• Contract Negotiation: Conduct high-level negotiations with major retail chains, PSAOs, specialty pharmacies, and mail-order partners to secure competitive reimbursement rates and advantageous contract terms without depending on spread pricing.

• Identify and create innovative network programs (e.g., high-performance or narrow networks, direct-to-consumer delivery models) aimed at reducing drug costs and enhancing member access.

• Oversee and evaluate the ongoing performance of the pharmacy network against established SLAs, ensuring compliance with contractual obligations, quality standards, and pricing accuracy.

• Direct the credentialing and re-credentialing processes, ensuring that all network pharmacies adhere to federal, state, and SmithRx regulatory standards.

• Supervise the pharmacy audit team to maintain network integrity, minimize Fraud, Waste, and Abuse (FWA), and effectively execute audit recoveries.

• Implement necessary policies and procedures to comply with CMS oversight requirements.

• Collaborate closely with Sales, Customer Success, Clinical Strategy, Pricing/Underwriting, and Product teams to ensure that network capabilities are accurately represented in the market and effectively integrated into our technology platforms.

• Work with data and analytics teams to monitor network profitability, utilization trends, and cost models, proactively identifying opportunities for financial optimization.

• Build, mentor, and expand a high-performing team of network managers, contracting specialists, and analysts, fostering a culture of accountability, integrity, and courage.

⛳️ Requirements

• 12+ years of progressive leadership experience in pharmacy network management, pharmacy contracting, or PBM operations.

• Experience across various lines of business: Commercial, Medicare, Medicaid, Exchange.

• In-depth understanding of the PBM ecosystem, pharmacy reimbursement models (AWP, MAC, NADAC), and the operational distinctions between traditional and pass-through/transparent PBMs.

• Proven success in negotiating complex, multi-million dollar contracts with major national pharmacy chains and PSAOs.

• Demonstrated ability to build, lead, and mentor cross-functional and remote teams in a high-growth environment.

• Strong financial and analytical skills with the capability to comprehend 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.

🏝️ Benefits

• Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, 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.