Director, PBM Pharmacy Network Contracting

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We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.

USD $ - USD $ /Yr.

M-F: 8:00 am - 5:00 pm

ATTENTION:
Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.

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, ensuring 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.

• 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.
  • 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, enforce ability, 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…