Job Details

Manager, Pharmacy Benefit Relations

Compensation: $135K-$145K (negotiable) + bonus and benefits
Location: Fully Remote (Working EST business hours)

Summary
Our client is a rare-disease specialty pharmacy focused on ultra-limited and exclusivetherapies. This role executes defined payer strategy by translating it into negotiated contract terms and sustainable reimbursement performance.
This is a hands-on payer strategy execution role within specialty pharmacy economics.

What You'll Do
• Manage the full PBM contracting lifecycle including redlines, negotiation, execution, and renewals
• Translate therapy strategy into contract terms aligned to reimbursement and margin goals
• Evaluate AWP/WAC methodologies, DIR structures, and economic impact
• Independently redline agreements and negotiate reimbursement terms
• Analyze claims-level reimbursement trends and identify underperforming contracts
• Partner with Finance, Billing, and Operations to resolve reimbursement issues
• Manage credentialing processes and maintain contract documentation
• Monitor payer performance and recommend contract adjustments as needed

What You Bring
• 7+ years of specialty pharmacy managed care experience
• Direct PBM negotiation and contracting experience
• Experience with rare disease or ultra-high-cost therapies
• Strong financial modeling and reimbursement analysis skills
• Ability to analyze claims-level data and margin impact
• Comfort working autonomously in a fully remote environment