Senior Manager, Pharmacy Pricing

Title: Senior Manager, Pharmacy Pricing

Location: USA

Job Description:

Full Time

Management

Remote

Requisition ID: 1905

In this multi-disciplinary, cross functional role, the Senior Manager, Pharmacy Pricing will report to the Director, Pharmacy Pricing & Analytics. The Senior Manager, Pharmacy Pricing is a leader and key contributor to the financial reporting, and client retention process and execution. This role is responsible for leading the team that executes, updates, and provides strategic direction for PBM pricing. Additionally, this role’s functions include client retention efforts with claim file requests, current account RFPs, and competing PBM comparisons. The Manager also assists with resolving client issues involving performance discrepancies and claims issues. This role will support the Director, Pharmacy Pricing & Analytics to continue to develop and support the process of evolving Pricing and Analytics functions. The successful Pharmacy Pricing 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 the RFP pricing process
• Leadership of the RFP 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 RFPs 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
• Manage the maintenance of PBM reference data including Specialty, Formulary, Exclusion, and Network lists
• 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

 

Required Skills / Experience:

• 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
• This position may work from our Birmingham, AL headquarters or remotely from home

 

Based on relevant market data and other factors, the anticipated hiring range for this role is $136,000 - $170,000 annually. Final compensation rates will be determined based on various factors, including but not limited to experience, skills, knowledge, and internal equity considerations. This role is also short-term incentive eligible. Incentive amounts will vary by individual and business goals. 

We are committed to fair and equitable compensation practices. The final salary offered to the selected candidate may vary from the posted range due to individual qualifications. Our goal is to ensure that all teammates are compensated fairly and competitively based on their contributions to our organization.

RxBenefits is also committed to providing best in class benefits to our teammates.  We offer a robust total rewards package that includes:

• 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