Ingenio RX Pharmacy Network Management Director
DescriptionSHIFT: Day Job
Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health care companies and a Fortune Top 50 Company.
IngenioRX Pharmacy Network Management Director
Responsible for strategic oversight of contract administration functions for the PBM contract with CVS Pharmacy. Acts as key subject matter expert on pharmacy network issues to ensure the company achieves related business objectives. Establishes and maintains policies, standards and training. Primary duties may include, but are not limited to:
- Directs contract administration including compliance with policies and procedures.
- Manages select external consultant relationships to expertly oversee CVS compliance with contractual terms and conditions.
- Oversees CVS management and reporting of pharmacy network contracting on behalf of company Plans.
- Develops and trains the PBM Contract Compliance team including implementation of PCCT SharePoint site to manage critical contract information and metric reporting.
- Coordinates with IngenioRx compliance team to monitor PBM to ensure compliance to contract.
- Provides monthly oversight of pricing performance across Commercial, Medicaid, and Medicare Part-D.
- Supports sales and account management with overall pharmacy pricing strategy.
- Provide expert consultation to company health plans on contract issues and potential resolutions.
- Develops and implements associate training.
- Prepares reports and works on special projects.
Requires a BS/BA degree in a related field; 3-5 years work experience in pharmacy networks contracting; or any combination of education and experience, which would provide an equivalent background. MBA preferred. 5-7 years experience in pharmacy networks contracting preferred.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.
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