Manager, Pharmacy Benefit Relations - Lake Mary, FL

Only for registered members Lake Mary, FL, United States

1 day ago

Default job background
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 ...
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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