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Salary: USD 123,300 - 174,000 / annual
SmithRx is a venture-backed healthtech company disrupting the Pharmacy Benefit Management (PBM) sector with a next-generation drug acquisition platform. The company has onboarded hundreds of thousands of members since 2016 and is focused on transforming the U.S. healthcare system through innovative cost-saving tools and best-in-class customer service.
The Pharmacy Network Contracting Manager is a highly autonomous senior individual contributor role supporting the Director of Contracting. This position serves as the principal process owner for day-to-day pharmacy network contracting operations while partnering closely with Provider Relations to support provider experience at scale.
Key responsibilities include:
- Leading day-to-day pharmacy contracting operations and serving as the principal subject matter expert, providing mentorship and process guidance to team members
- Owning and optimizing the contracting pipeline (intake, prioritization, aging, execution timelines, and deliverables)
- Governing the end-to-end contract lifecycle across new agreements, amendments, renewals, notices, and terminations
- Leading complex contract negotiation workflows and redline reviews in partnership with Legal and internal stakeholders
- Ensuring reimbursement exhibits, fee schedules, and effective dates are accurate, approved, and implementation-ready
- Driving rate loading and network configuration in the claims adjudication system to ensure executed terms are implemented accurately and on time
- Architecting and enforcing controls and QA frameworks for rate setup, including effective dates, plan/network mapping, reimbursement logic, and exception handling
- Monitoring and managing the rate load/configuration backlog, prioritizing urgent builds, and escalating risks that could impact go-lives or claim outcomes
- Owning post-load validation checkpoints (test claims, spot checks, variance reviews) and leading root-cause analysis
- Partnering strategically with Provider Relations to align contracting timelines, onboarding requirements, and provider communications
- Acting as the escalation point for contracting- or configuration-related provider escalations
- Authoring and maintaining contracting playbooks, SOPs, templates, and standard responses
- Driving contract repository and configuration documentation governance
- Providing routine reporting on contracting/configuration volume, cycle time, backlog, and issue trends; leading continuous process improvement initiatives
- Architecting and maintaining a comprehensive contracting knowledge base to drive internal enablement
Requirements:
- Bachelor's degree or equivalent relevant experience in PBM, managed care, healthcare contracting, network operations, or provider relations
- 8+ years of experience in pharmacy/provider contracting, PBM network operations, or healthcare contract administration
- 2+ years of experience serving as a principal subject matter expert, process owner, and/or managing high-volume contracting workflows
- Exceptional ability to interpret complex contract language, lead redline negotiations, and strategically identify business, operational, and compliance risks
- Deep technical understanding of claims adjudication and pharmacy reimbursement configuration
- Proven experience architecting or overseeing rate loading and configuration accuracy, including effective-date controls and mapping requirements
- Demonstrated ability to work provider-facing issues through resolution while balancing contracting standards and operational feasibility
- Advanced cross-functional stakeholder management skills across Provider Relations, Legal, Pricing, Credentialing, Operations, Compliance, and Finance
- Excellent written and verbal communication skills with ability to clearly document complex issues, decisions, and next steps
- Meticulous attention to detail and ability to autonomously manage competing priorities and deadlines
- Advanced proficiency with Excel/Google Sheets and contract tracking/document management practices
- PBM pharmacy network experience (retail, PSAO/independents, specialty) preferred
