Vice President of Pharmacy Networks
Full-time
SmithRx
What you will do:
Network Strategy & Contracting
- Lead Network Strategy: Design and execute the overarching strategy for SmithRx’s national and custom pharmacy networks, ensuring alignment with our transparent business model and client needs.
- Contract Negotiation: Lead high-level negotiations with major retail chains, PSAOs, specialty pharmacies, and mail-order partners to secure competitive reimbursement rates and favorable contract terms without relying on spread pricing.
- Strategic Partnerships: Identify and develop innovative network programs (e.g., high-performance or narrow networks, direct-to-consumer delivery models) to drive down drug costs and improve member access.
Network Management & Operations
- Oversee Network Performance: Monitor and manage the ongoing performance of the pharmacy network against defined SLAs, ensuring adherence to contractual terms, quality standards, and pricing accuracy.
- Credentialing & Compliance: Direct the credentialing and re-credentialing processes, ensuring all network pharmacies comply with federal, state, and SmithRx regulatory standards.
- Audit & Fraud Prevention: Oversee the pharmacy audit team to manage network integrity, minimize Fraud, Waste, and Abuse (FWA) , and execute audit recoveries effectively.
- Government programs readiness: Implementation of needed policies and procedures to meet CMS oversight requirements .
Cross-Functional Leadership
- Internal Alignment: Partner closely with Sales, Customer Success, Clinical Strategy, Pricing/Underwriting, and Product teams to ensure network capabilities are accurately represented in the market and successfully integrated into our technology platforms.
- Data & Analytics: Collaborate with data and analytics teams to monitor network profitability, utilization trends, and cost models to proactively identify areas for financial optimization.
- Team Development: Build, mentor, and scale a high-performing team of network managers, contracting specialists, and analysts. Foster a culture of accountability, integrity, and courage
What you will bring to SmithRx:
- Experience: 12+ years of progressive leadership experience in pharmacy network management, pharmacy contracting, or PBM operations.
- Experience across lines of business: Commercial, Medicare, Medicaid, Exchange
- Industry Expertise: Deep understanding of the PBM ecosystem, pharmacy reimbursement models ( AWP, MAC, NADAC ), and the operational differences between traditional and pass-through/transparent PBMs.
- Negotiation Skills: Proven track record of successfully negotiating complex, multi-million dollar contracts with major national pharmacy chains and PSAOs.
- Leadership: Demonstrated experience building, leading, and mentoring cross-functional and remote teams in a high-growth environment.
- Analytical Acumen: Strong financial and analytical skills with the ability to understand complex pricing models and translate data into actionable network strategies.
- Education: Bachelor’s degree in Business, Healthcare Administration, Finance, or a related field; PharmD or Master’s degree (MBA/MHA) is highly preferred .
Vacancy posted 10 days ago
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