Georgia Employer CONTRACT MANAGER - PHARMACY NETWORK in Atlanta, Georgia
McKesson requires new employees to be fully vaccinated for COVID-19 as defined by the CDC, subject to applicable, verified accommodation requests.CoverMyMeds, part of McKesson Corporation, is a fast-growing healthcare technology company that has been recognized as a "Best Place to Work" by Glassdoor and a "Best Company to Work For" by FORTUNE. Through innovation and collaboration, CoverMyMeds' solutions help people get the medicine they need to live healthier lives by seamlessly connecting the healthcare network to improve medication access; thereby increasing speed to therapy and reducing prescription abandonment. CoverMyMeds' network includes 75 percent of electronic health record systems (EHRs), 50,000+ pharmacies, 750,000 providers and most health plans and PBMs.Position DescriptionThe Pharmacy Network Contract Manager is responsible for providing support related to the pharmacy network contracting functions of the company collaborating and coordinating with the teams supporting discount programs and related products and solutions requiring a participating pharmacy network. The position is responsible for developing and maintaining relationships with pharmacy service providers, including performing and/or assisting with negotiating service contracts, resolving issues and appeals associated with participating pharmacy network contracts.Key ResponsibilitiesContractingProvide sales support for contract negotiations with Chain, PSAO, and Independent pharmacy network providers for products and associated product lines of business and acts as the liaison regarding product / pricing modifications and on-going negotiations.Works with pricing, data scientist, product mgt, and external partner to capture, implement, and maintain network guarantee requirements (Generic Effective Rates, Brand Effective Rate, Specialty Effective Rate, Administration Fee Effective Rate), and reviews and provides final provider guarantee reconciliations and analyses to achieve overall network and client financial obligations.If required, credential providers for participation in products and associated product lines of business pharmacy networksBe the subject matter expert on standard pharmacy services agreement language including compliance and performance measuresMaintain a detailed level of understanding of participating pharmacy network products and servicesUnderstand the complex relationships between various pharmacy types, e.g. Chains, Independents, Health Systems, etc., their lines of business, and how those affect the demographics of the participating pharmacy networkManage the implementation of contract language and reimbursement terms into adjudication platform including assessing new customer/partner requirements in conjunction with the adjudication architect.Administration and ComplianceEffectively identifies pharmacy network setups and configuration issues to claims processing, proposing sustainable solutions or immediate resolutions.Provides support in tracking and maintain pharmacy network rate information.Fully understand the various aspects of a prescription claim.Working cross departmentally, establish and maintain standard operating procedures and policies to manage and resolve contract and price appeals with participating pharmacies.Working cross departmentally, create and publish policies and procedures regarding pharmacy provider network contractingProperly store contract documentationDevelop a thorough understanding of the network structure of products and associated channel partners and reseller clientsSupport coordinate with Account Managers handling client inquiries and requirements for any pharmacy provider network functionsInitiates and assists coordination with internal teams,... For full info follow application link.McKesson is an equal opportunity and affirmative action employer - minorities/females/veterans/persons with disabilities.