Seeking a PBM Network Process Manager! The selected candidate will have oversight of networks including specialty. This is an operations oversite and management role where the business would like someone with a knowledge of pharmacy networks (retail, mail, specialty, etc..) who can take a pharmacy contract and manage the following entities; performance matrix, credentialing, re-contracting, and regulatory compliance. The candidate must possess the following skills:

1. Network performance analysis - Monitoring access, disruptions, trends, and service quality.
2. Provider relationship management - Engaging with pharmacy networks and resolving escalations.
3. Data-driven decision making - Using performance data to guide contracting, retention, and outreach.
4. Operational optimization - Driving improvements in network access, satisfaction, and cost efficiency.
5. Cross-functional collaboration - Coordinating with stakeholders across business, operations, and regulatory teams.

- Monitor key performance metrics such as claims volume, turnaround times, network adequacy, and member satisfaction.
- Support credentialing, re-contracting, and termination processes across all network pharmacy providers.
- Ensure alignment of network operations with contractual, regulatory, and service-level standards.
- Coordinate with internal stakeholders to address network performance concerns and ensure resolution.

Required Skills

- Experience: 8 years relevant systems/technical analysis
- Education Level: Bachelor's Degree - In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

This is an operations oversite and management role where the business would like someone with a knowledge of pharmacy networks (retail, mail, specialty, etc..) who can take a pharmacy contract and manage the following entities; performance matrix, credentialing, re-contracting, and regulatory compliance. The candidate must possess the following top 5 Mandatory Skills:

1. Network performance analysis - Monitoring access, disruptions, trends, and service quality.
2. Provider relationship management - Engaging with pharmacy networks and resolving escalations.
3. Data-driven decision making - Using performance data to guide contracting, retention, and outreach.
4. Operational optimization - Driving improvements in network access, satisfaction, and cost efficiency.
5. Cross-functional collaboration - Coordinating with stakeholders across business, operations, and regulatory teams.