What you'll do
In a few words…
Smart, organized, and flexible leader with web-weaving capacities who can provide support and handle the intricacies of working in a Network. The Network Strategy Operations Manager (That's the official title, but you can call yourself NETSOM or whatever cool name you feel best suits your duties.), will be responsible for managing and performing incredible circus feats of balancing the Company's initiatives and projects as they relate to Pharmacy Networks. Your collaborative and leadership qualities will shine as you work to ensure Abarca meets and exceeds the requirements and obligations to our clients and pharmacy partners as outlined in our Provider Network Agreement. You'll also play a key role in project managing initiatives for product enhancement as directed by Network Strategy leadership in order to ensure proper execution. As a manager with great interpersonal skills, you will also be a primary point of contact for leading network implementations in alignment with Client Services. Somebody has to be, right? And let's not forget that you should possess some chiropractic skills because you will be the accountable party when it comes to aligning pharmacy partners, clients, and adjudication enhancements from the Network Strategy perspective.
The fundamentals for the job…
- Support in the development of network strategies for US mainland and in Puerto Rico, including participants, network size, reimbursement drivers and terms (discounts, DIR, incentives), quality criteria, and other contracting elements;
- Serve as the leader in Network Strategy to support client network implementation and be able to ascertain all requirements for either smooth onboarding or for requesting system enhancements (You're a Natural Born Leader, it will be a piece of cake.)
- Serve as the primary point of contact for Client Services with Pharmacy Network related questions and projects
- Lead the investigation of and submit or delineate network configuration requirements to the configurations teams (Leading Investigator sounds cool doesn't it?)
- Support QA and testing of configurations once implemented
- Work with performance monitoring to ensure proper maintenance of configurations
- Lead the project management aspects and provide support in Pharmacy Network related adjudication enhancements with Product Strategy
- Establish and maintain relationships with pharmacy chains and PSAOs as operational support
- Establish an active role in NCPDP and be the SME for pharmacy data and telecommunications
- Understand analytical tools and reports to ensure contract compliance and alignment with network objectives
- Support and align with Pharmacy Training teams on network education and other outreach initiatives
- Participate and support business development activities as requested (And the Oscar for supporting Abarcan in a leading role goes to...INSERT YOUR NAME HERE.)
What you're made of
The bold requirements…
- Bachelor's Degree in Pharmacy, Business, Mathematics, or related field (In lieu of a degree, equivalent relevant work experience may be considered.)
- 3+ years of professional experience, preferably within a PBM or health plan
- Strong understanding of NCPDP pharmacy and telecommunications data (Think Hercules strong.)
- Previous underwriting or financial analysis and marketing experience with PBM or health plans would make you shine brighter than the LED light of your air conditioner.
- Strong understanding of PBM client LOB: Commercial, Employer Groups, Health Plans, Medicare Part D, Medicaid, 340B, Discount Card
- Strong understanding of Pharmacy LOB: Retail, Long Term Care, Home Infusion, Mail Order, Specialty, Institutions
- Basic understanding of Pharmacy Relationships: Chains, PSAOs, Independents
- This position requires Jedi Master computer proficiency. That means you can teach Bill Gates a thing or two about Microsoft Office (Word, Excel, PowerPoint) products, and your Internet surfing and research skills are Pipeline Master Champ levels.
- It's a good thing you love to learn because this position will require you maintain expert knowledge of the PBM industry, current/emerging pharmacy trend management strategies, and current/emerging Abarca product offerings.
- Maxed out and OP interpersonal skills with an excellent ability to work well with all levels of internal management and staff, as well as outside clients and vendors.
- Must be available for occasional travel to the main office for team events, industry conferences, client visits, and corporate pharmacy meetings.
Nice to have… (Adds bonus points and happy face stickers.)
- Experience in a Provider Relations, Chain Pharmacy, PSAO, Client Service or Relationship Management role (preferred)
- You can communicate effectively (read, write, speak, daydream, argue, flatter, chatter, and Google stuff, etc.) in English.
- We would prefer it if you had some experience in managing direct reports (preferred)
That something extra we´d love to see…
- Adjustable: Like a one-sized belt, you can adjust to any situation with ease. You know circumstances and priorities are always changing which is why you love to put dimmers on your lights.
- Collaborator: You're the human embodiment of balance, yin & yang, harmony, equilibrium, etc. When the quarks joined to form a neutron, you were there, supervising. Your presence practically guarantees a happy medium.
- Fixer/Tinker of Problems: You collect problems and keep yourself busy fixing them in creative and sometimes unusual ways. There's nothing you can't fix. Old broken-down machines make you giddy.
- Structured: Order and structure are a biological need to you. You can't help organizing other people's desks and we can safely assume your LEGOs are neatly stored by color and type and all hell will break loose if someone puts a piece in the wrong compartment. Relax. We won't do that. If fact, could you come over and organize ours? We know your crazy organization make everything more efficient.
- Accountable: You're one of the most, if not THE most reliable person in the room. You own up to what you say and do, and correct things when you make mistakes. Honesty and loyalty are your most prized assets.
The above description is not intended to limit the scope of the job or to exclude other duties not mentioned. It is absolutely not a final set of specifications for the position. It's simply meant to give readers an idea of what the role entails.
Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of gender, race/ethnicity, gender identity, sexual orientation, protected veteran status, disability, or other protected group status.