Pharmacy Vendor Manager

Job Summary :

Reporting to the Manager of Pharmacy Contracting and Reporting, the Pharmacy Vendor Manager is a key strategic leader responsible for overseeing relationships and contracts with pharmacy benefit managers (PBMs) and specialty pharmacy vendors. This position ensures that vendor performance aligns with contractual and regulatory obligations but as well as with the organization's long-term strategic goals. The Pharmacy Vendor Manager will work closely with senior leadership to identify and leverage opportunities for innovation and improvement within the pharmacy benefits space, driving initiatives that enhance value and optimize outcomes across Medicaid, Medicare, and commercial markets.

Key Functions / Responsibilities :

• Lead and manage the organization's relationships with PBMs and other pharmacy vendors, ensuring alignment with the organization's broader strategic goals. Serve as a subject matter expert on PBM functions, market trends, and regulatory impacts.
• Develop and refine strategies for contract negotiations and performance management, with a focus on maximizing value through enhanced contract terms, cost savings, and innovative service delivery models. Ensure vendors meet service level agreements (SLAs) and performance metrics, with particular attention to regulatory requirements and market changes.
• Monitor vendor performance and compliance through strategic data analysis, anticipating potential issues and addressing them proactively. Oversee corrective action processes, ensuring vendor accountability for service delivery, compliance, and performance deficiencies.
• Generate high-level reports and insights for senior leadership on vendor performance, compliance, cost trends, and emerging pharmacy benefit challenges. Leverage data to inform decision-making and identify opportunities for program improvements and cost optimization.
• Act as a central liaison across multiple departments-Compliance, Finance, Legal, and Clinical teams-to ensure a coordinated approach to pharmacy benefits management. Foster collaborative relationships to drive initiatives that improve internal processes and member outcomes.
• Stay abreast of industry trends and regulatory changes, particularly around PBM practices and policies. Lead efforts to adjust strategies in response to market and legislative developments that affect the organization's pharmacy benefits programs.
• Collaborate with internal teams and vendors to explore and implement innovative pharmacy solutions (e.g., value-based contracting, specialty pharmacy models) that drive quality care, cost-efficiency, and member satisfaction.
• Lead governance of vendor contracts and performance by organizing and leading regular executive-level meetings with vendors. Drive accountability for long-term vendor strategy and continuous improvement.
• Oversee pharmacy network adequacy and performance, ensuring alignment with strategic priorities such as network optimization, geo-access standards, and cost-efficiency. Ensure directory accuracy and ongoing compliance with applicable regulations.
• Lead efforts to mitigate vendor-related risks by conducting in-depth assessments. Ensure vendor compliance with all contractual, regulatory, and financial obligations.
• Present findings and recommendations to senior leadership, influencing decision-making and policy development related to PBM oversight and pharmacy strategy.
• Contribute to strategic initiatives across the organization as needed, ensuring the pharmacy benefits space is positioned for future growth and regulatory compliance.
• Other duties as assigned

Supervision Exercised :

Supervision Received :

Qualifications : Education Required :

Education Preferred :

Experience Required :

Experience Preferred / Desirable :

Required Licensure, Certification or Conditions of Employment :

Competencies, Skills, and Attributes :

Working Conditions and Physical Effort :