Director, Pharmacy Network Pricing & Market Planning

About This Opportunity

We are representing a confidential pharmacy benefit management organization that is expanding its network pricing leadership team. Our client is seeking a Director, Pharmacy Network Pricing & Market Planning to own pharmacy network financial performance across all lines of business.

This is a remote opportunity available to candidates in most U.S. states. Our talent team at Get A Job.ai is conducting the initial screening process for this director-level position.

Responsibilities

• Own pharmacy network financial performance across all lines of business, with direct accountability for achieving contracted reimbursement guarantees, including effective rate performance and MAC pricing outcomes
• Lead the Network Reconciliation function with full accountability for validating pharmacy network performance against contracted effective rates and pricing guarantees
• Establish and enforce processes to monitor, measure, and report on network performance versus contractual targets
• Identify performance variances and drive corrective actions in partnership with network contracting and pricing teams
• Ensure audit readiness, financial transparency, and governance across all reconciliation activities
• Lead the MAC Pricing team with accountability for development, maintenance, and performance of enterprise MAC pricing
• Oversee ongoing monitoring of claim-level reimbursement performance to identify outliers and pricing inefficiencies
• Drive timely MAC adjustments to address performance gaps, market changes, and provider behavior
• Establish governance and controls to ensure MAC pricing is competitive, compliant, and aligned with enterprise financial goals

What We're Looking For

• Bachelor's degree in Business, Finance, Economics, Healthcare Administration, or related field, or equivalent work experience required
• 7+ years of progressive pharmacy benefit management, healthcare plan, pharmacy network, or related experience required
• 3+ years of leadership experience with proven ability to develop high-performing teams and deliver tangible results in a professional services environment required
• Demonstrated experience in pricing strategy, market analysis, or network planning required
• Experience supporting RFP pricing and competitive market analysis required
• Prior experience leading or matrix-management experience preferred
• Strong analytical skills with ability to translate network pricing strategies into realized financial outcomes

How We Work With You

When you apply through Get A Job.ai, one of our experienced recruiters will review your qualifications and conduct an initial screening. If there's a strong match, we'll submit your profile to our client for consideration. Please do not attempt to contact the employer directly, as all applications must come through our recruitment process to be considered.

This is a full-time, remote position available to candidates in most U.S. states (some state restrictions apply). The work schedule is Monday through Friday, standard business hours.

Pay

Compensation details will be discussed during the screening process with our recruitment team.

Equal Employment Opportunity

Get A Job.ai is committed to providing equal employment opportunity in our recruitment services. We welcome applicants from all backgrounds and do not discriminate on the basis of race, color, religion, sex, national origin, age, disability, veteran status, or any other protected characteristic.