Job Description

Job Title: Pharmacy Network Manager/Analyst (Oversight of networks including specialty) Location: OFFSITE - Must be located in one of the following states to apply: Maryland, Virginia, West Virginia, District of Columbia, North Carolina, Pennsylvania, Delaware, Florida, New York, New Jersey, and Texas. Role Type: Contract 12+ months - likely extensions or perm rollover Contractor Work Model: 100% Remote We are seeking a Pharmacy Network Manager to oversee and optimize our pharmacy provider network operations. This is not a technical role. The ideal candidate will have experience managing relationships and contracts with pharmacy providers across retail, mail-order, and specialty networks. The role requires strong organizational and vendor management skills, with a focus on performance monitoring, compliance, and service-level adherence. Responsibilities include: + Manage contracts with pharmacy providers across multiple network types (retail, mail-order, specialty). + Oversee and support credentialing, re-contracting, and termination processes with network pharmacies. + Monitor and evaluate network performance metrics such as claims volume, turnaround times, network adequacy, and member satisfaction. + Ensure network operations are compliant with regulatory, contractual, and internal service-level agreements (SLAs). + Collaborate with internal departments (e.g., compliance, operations, legal) to resolve performance or contractual issues with vendors and providers. + Maintain relationships with external vendors and ensure alignment with business goals and regulatory standards. Knowledge, Skills, and Abilities: + Strong understanding of pharmacy networks and provider management. + Familiarity with pharmacy contract terms and SLAs. + Excellent organizational and project management skills. + Strong interpersonal and communication skills; able to work cross-functionally. + Ability to evaluate vendor performance and implement process improvements. + Knowledge of regulatory requirements impacting pharmacy networks is a plus. Experience: + Minimum 8 years of relevant experience in healthcare, pharmacy benefit management (PBM), or pharmacy network operations. + Experience working with or managing pharmacy networks, including contract oversight and vendor performance evaluation. Education Level: Bachelor's Degree Education Details: Computer Science, Information Technology, or related field In Lieu of Education In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience. Preferred Qualifications Advanced degree Prior experience with pharmacy benefit managers (PBMs) or health plans. Understanding of credentialing and compliance processes for pharmacy networks. Ability to navigate through various complex systems, deliver quality solution within budget and schedule. Ability to understand projects and concepts as they relate to high-level business objectives. Strong interpersonal skills and ability to work in a team-based environment Understanding of Project Management and translating organization objectives into goals #M2 Ref: #855-IT Baltimore System One, and its subsidiaries including Joulé, ALTA IT Services, CM Access, TPGS, and MOUNTAIN, LTD., are leaders in delivering workforce solutions and integrated services across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible full-time employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan. System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

Job Tags

Permanent employment, Full time, Contract work, For contractors, Work experience placement, Local area, Remote job,

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