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DIRECTOR, PAYOR RELATIONS AND CONTRACTING

Date Posted: Jul 31, 2026
Yearly: USD - USD

Job Detail

  • location_on
    Location Louisville, Kentucky, United States of America
  • desktop_windows
    Job Type: Permanent
  • schedule
    Shift:
  • analytics
    Career Level:
  • group
    Positions:
  • calendar_view_day
    Experience:
  • male
    Gender: No Preference
  • school
    Degree:
  • calendar_month
    Apply Before: Oct 29, 2026

Job Description

Overview

PharMerica Job OpportunityResponsible for strategic development and execution of PBM and 3rd Party Payor contracting for PharMerica LTC Pharmacy business units.Oversees all Pharmacy PBM and 3rd Party Payor contracting process for LTC PharMerica business unit. This includes Medicare Part D, Commercial and Managed Medicaid.Manage and negotiate national 3rd Party Payor and PBM contracts to ensure company's objectives are met in a timely manner.Develops and executes a dynamic and strategic PBM and Payor strategy to support annual plan and business objectives. This includes effectively managing GER, BER and reconciliation processes.Responsible for financial oversight of the department including underwriting and auditing of all potential and existing contracts while working collaboratively with financial and operational leaders.Analyzes applicable Pharmacy PBM and 3rd Party Payor contracts, associated documentation and proposed fees, and negotiates financial terms of contracts.Oversees all components of contracting process, database management and communication to all business owners.Participates and effectively manages all cross-functional needs to efficiently support the flawless implementation of new contractual relationships and collaboration with all appropriate internal stakeholders.Provides market segment performance and feedback to the leadership team.Significant understanding of the PBM and 3rd Payor landscape, national and regional, and reimbursement processes across LTC Pharmacy business segment.Directs and performs analysis necessary to ascertain PBM and Payor compliance with contractual obligations.Excellent communication, executive presence, and interpersonal skills with demonstrated proficiency to advance business objectives cross-functionally.Understanding and working knowledge of PBM and 3rd Party Payor program metrics, methodologies and recoupment processes.Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.Required: Bachelor's degree in business administration, Life Sciences or related fieldDesired: MBARequired: Ten (10) or more years of related PBMRequired: Ten (10) or more years of health-plan contracting or provider experienceDesired: Fifteen (15) or more years of management experience in healthcare settingRequired: Strong analytical, communication, management and relationship skillsRequired: Advanced knowledge of Microsoft Office products (Excel, Word, Powerpoint), Power BI or SASRequired:Desired:Required: 25% (Trade Shows, Association meetings, etc.)DesiredPharMerica, an affiliate of BrightSpring Health Services, is a full-service pharmacy solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations, and post-acute care organizations. PharMerica is one of the nation's largest pharmacy companies, offering unmatched company culture, employee development, and advancement opportunities.

Key responsibilities

Not specified in the original listing.

Required skills

  • Executive Positions

What the company offers

Not specified in the original listing.

Skills Required

Company Overview

Jeffersonville, South Georgia, United States of America

BrightSpring Health Services delivers innovative and compassionate health and social services to help individuals live their best lives. With a focus on promoting independence and quality of life, the company offers a variety of healthcare solutions... Read More

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