Director, PBM Pharmacy Network Contracting

The Director, Pharmacy Network Contracting is responsible for leading the negotiation, execution, and ongoing management of pharmacy network contracts across all provider segments. This role holds direct accountability for contract strategy, provider agreements, and the financial outcomes of negotiated reimbursement structures.

The Director serves as the contracting authority for pharmacy provider agreements, leading negotiations with national chains, grocers, PSAOs, and independent pharmacies. This role ensures that contract terms are competitive, sustainable, and aligned with enterprise pricing strategy, regulatory requirements, and long-term network objectives.

This role partners closely with the Senior Director, Network Contracting to drive contracting strategy, establish negotiation priorities, and ensure alignment with enterprise network and financial objectives.

Is this you? Find out more below!

Network Contracting & Negotiation Leadership

Lead negotiation of pharmacy participation agreements across all provider segments, including national chains, grocers, PSAOs, and independent pharmacy networks.
• Own reimbursement structures, contract terms, and financial outcomes of pharmacy provider agreements.
• Establish negotiation strategies that balance market competitiveness with enterprise financial and network performance goals.
• Serve as the decision-maker for contract structure, rate positioning, and escalated negotiation decisions.
• Approve contract exceptions and ensure alignment to broader network strategy and pricing objectives.

Contract Strategy & Framework Development

• Provide strategic leadership over pharmacy participation agreements, network addenda, and contract standards, ensuring consistency with enterprise pricing, access, and compliance objectives.
• Develop and maintain contracting playbooks, standards, and governance frameworks to support scalable and consistent negotiation practices.
• Guide contract structure decisions to support evolving pricing strategies, regulatory changes, and market dynamics.
• Recommend enhancements to contract language and structure to improve clarity, enforceability, and long-term sustainability.

Provider Engagement & Negotiation Strategy

• Lead provider engagement strategy to support successful contract negotiations, alignment to contract intent, and long-term network stability.
• Serve as a senior point of contact for complex and strategic provider discussions, including reimbursement changes, contract interpretation, and structural alignment.
• Maintain strong relationships with key pharmacy partners to support transparency, issue prevention, and alignment on contract expectations.
• Drive resolution of high-impact or systemic provider issues, ensuring alignment to contract terms and enterprise objectives.

Contract Execution & Cross-Functional Alignment

• Ensure negotiated contract terms are clearly defined, documented, and positioned for accurate downstream implementation.
• Partner with Network Operations and Performance teams to support effective handoff, implementation, and validation of contract terms.
• Provide strategic guidance on contract interpretation to support claims configuration, pricing application, and network governance.
• Support enterprise initiatives related to network strategy, growth, and regulatory readiness.

Financial Accountability & Performance Alignment

• Accountable for financial performance of pharmacy network contracts, ensuring negotiated reimbursement terms align with enterprise pricing strategy and expected outcomes.
• Partner with Network Performance and Reconciliation leadership to ensure contracted terms are operationalized and achieved through effective execution and monitoring.
• Incorporate performance insights and market feedback into future negotiation strategies and contract design decisions.

Issue Resolution & Continuous Improvement

• Act as escalation point for complex, high-risk, or systemic contract issues requiring higher-level leadership intervention.
• Analyze trends in provider inquiries, disputes, and operational friction to identify opportunities for structural contract improvement.
• Drive continuous improvement initiatives to enhance contract clarity, reduce administrative burden, and improve provider experience.

Leadership & Team Development

• Provide leadership and direction to contract managers and/or senior contracting staff.
• Set expectations for negotiation discipline, contract quality, documentation, and escalation standards.
• Foster a high-performing team environment focused on accountability, consistency, and execution excellence.

What our team expects from you?

• Bachelor's degree in Business, Finance, Economics, or Healthcare Administration, or related field, or equivalent work experience, required.
• 7+ years of progressive PBM, healthcare plan, pharmacy network, or equivalent experience required.
• Demonstrated experience in provider contracting, contract strategy, or network governance required.
• Strong understanding of pharmacy reimbursement and claims adjudication concepts required.
• 3+ years of leadership experience with a proven ability to develop high-performing teams and deliver tangible results in a professional services environment required.
• Participate in, adhere to, and support compliance program objectives.
• The ability to consistently interact cooperatively and respectfully with other employees.

What can you expect from Navitus?

• Top of the industry benefits for Health, Dental, and Vision insurance
• 20 days paid time off
• 4 weeks paid parental leave
• 9 paid holidays
• 401K company match of up to 5% - No vesting requirement
• Adoption Assistance Program
• Flexible Spending Account
• Educational Assistance Plan and Professional Membership assistance
• Referral Bonus Program - up to $750!

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