Manager, Pharmacy Benefit Relations - Lake Mary, FL
1 day ago

Job description
Compensation: $135K-$145K (negotiable) + bonus and benefits
Location: Fully Remote (Working EST business hours)
Summary
Our client is a rare-disease specialty pharmacy focused on ultra-limited and exclusive therapies. This role executes defined payer strategy by translating it into negotiated contract terms and sustainable reimbursement performance.
This is a hands-on payer strategy execution role within specialty pharmacy economics.
What You'll Do
- Manage the full PBM contracting lifecycle including redlines, negotiation, execution, and renewals
- Translate therapy strategy into contract terms aligned to reimbursement and margin goals
- Evaluate AWP/WAC methodologies, DIR structures, and economic impact
- Independently redline agreements and negotiate reimbursement terms
- Analyze claims-level reimbursement trends and identify underperforming contracts
- Partner with Finance, Billing, and Operations to resolve reimbursement issues
- Manage credentialing processes and maintain contract documentation
- Monitor payer performance and recommend contract adjustments as needed
What You Bring
- 7+ years of specialty pharmacy managed care experience
- Direct PBM negotiation and contracting experience
- Experience with rare disease or ultra-high-cost therapies
- Strong financial modeling and reimbursement analysis skills
- Ability to analyze claims-level data and margin impact
- Comfort working autonomously in a fully remote environment
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