Manager, Specialty Pharmacy Payer Relations

Meijer Inc. | Grand Rapids, MI

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Posted Date 10/07/2021

Today, with our current team members, we have the strength to help you grow in any career direction you want, whether in our stores, distribution centers, manufacturing facilities or our Midwest corporate offices.  It's your future, maybe it starts with Meijer.

Please review the job profile below and apply today!

This position targets and develops relationships with health plans, PBMs and other payers to increase access to new and expand opportunities within existing payer networks. The goal of this position is to facilitate the best possible patient experience through expanded payer access & programs while meeting/exceeding targets for pharmacy sales and margin. This position manages payer outreach, negotiations and relationships and works with internal teams to ensure effective contract execution and compliance.


What You'll Be Doing:

  • Implements and manages specialty payer targeting strategy including but not limited to health plans and pharmacy benefit managers (PBMs)
  • Collaborates with pharmacy leadership, managed care and specialty sales teams to identify and evaluate prospective payer targets
  • Prioritizes, tracks and manages payer opportunities longitudinally
  • Analyzes health care trends and disruptors impacting the payer segment
  • Manages the evaluation of and response to payer RFPs 
  • Collaborates with the manager of third party programs to evaluate and negotiate payer contracts
  • Works with specialty operations, clinical, trade relations and accreditation teams to ensure that contract provisions align with other business requirements and expectations
  • Partners with pharmacy business intelligence to deliver contractual reporting requirements
  • Is accountable to overall contract performance, including monitoring the financial and operational performance of payer contracts
  • Responsible for all aspects of the client relationship to ensure client satisfaction and retention
  • Works with payer clients to determine, measure and report KPIs
  • Coordinates and leads quarterly business reviews with strategic payer accounts
  • Serves as point of contact for client questions and concerns
  • Develops and manages medical billing capabilities
  • Works with cross-functional teams (e.g. ITS, pharmacy merchandising) to develop new services, tools & solutions meaningful to payer clients
  • Engagement with key industry trade and managed care organizations

What You'll Bring With You:

  • Bachelor of Science in pharmacy or Doctor of Pharmacy degree preferred
  • Bachelor’s degree in business, health care or related field minimum
  • Minimum 5 years specialty pharmacy or relevant pharmaceutical industry experience
  • Licensed pharmacist preferred
  • Contract negotiation experience preferred
  • Existing customer relationships within the health care industry preferred
  • Knowledge of the market, specialty business and customers
  • Leadership experience
  • Planning skills
  • Negotiation skills
  • Awareness of legislative environment impacting payer dynamics
  • Enthusiasm, initiative and passion for pharmacy
  • Mentoring and team building skills
  • Interpretation of data to provide meaningful analysis for leadership
  • Office computer skills: able to learn company systems and tools, preference for Microsoft application experience



Job Type
Full time

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