Lead Director - Medical Pharmacy Network
$100,000–$231,540 year
On-siteHartford, Connecticut, United States
Job Summary
Drive network strategy and performance improvement for medical drug reimbursement across hospital, health system, and regional provider partners. Enable market teams with contracting guidance, analytics, and best practices to improve cost, quality, and access outcomes. Develop Market Network contract relationships providing support for market agreements and negotiations with health systems, hospitals, and regional provider groups. Align broader medical pharmacy strategy with National Ancillary Network and Value-Based Care teams while designing strategic retail network initiatives by analyzing market trends and assessing competitive advantages. Control all systems monitoring the performance of the medical pharmacy and infusion provider network, subsequently analyzing key performance indicators and identifying specific areas for improvement. Communicate with external stakeholders, including healthcare organizations and insurance providers, to establish partnerships and collaborative arrangements. Align retail provider network strategies with legal and regulatory frameworks, ensuring critical compliance with all relevant health regulations and standards. Advise senior management and stakeholders on provider network performance, patient expectations and outcomes, and key financial metrics and targets.
Required Qualifications
- At least 10 years of experience in health plan operations, network contracting, or provider-facing contracting environments
- At least 3 years of experience in a health plan setting, with exposure to payer operations and healthcare administration
- Demonstrated ability to translate complex contracting, financial, and operational information into concise, executive-level narratives that drive informed decision-making, align stakeholders, and communicate business value effectively
- Proven ability to critically evaluate contract terms, reimbursement structures, and business proposals, confidently challenging unfavorable provisions and advocating for solutions that mitigate risk, protect organizational interests, and support long-term strategic objectives
- Demonstrated knowledge of medical pharmacy reimbursement and outpatient reimbursement models, including payer and provider considerations
Desired Qualifications
- Experience with health system and hospital network contracts
- Contracting experience with infusion, medical pharmacy arrangements, and/or value-based care
- Bachelor's degree preferred or a combination of education and work experience
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