Pharmacy Network Director - Specialty Pharmacy

Job Description

Job Description

AscellaHealth | Berwyn, PA | Hybris work schedule (3 days in office)

Shape the Future of Healthcare

We're seeking a Pharmacy Network Director to join our dynamic team at AscellaHealth, where your expertise will directly contribute to improving health outcomes for patients with complex, chronic conditions and rare diseases. This role offers the opportunity to lead and execute the strategic, operational, and financial management of the organization's pharmacy networks, including retail, specialty, mail order, and home infusion. This leader will be accountable for network design, contracting, reimbursement strategy, appeals, access, and performance across all channels. The incumbent will lead all contractual and negotiation activities with these vendors, collaborating closely with internal stakeholders to ensure alignment with organizational goals and compliance with operational standards.

The Pharmacy Network Director will identify, negotiate, and execute new Pharmacy Network agreements, oversee the MAC list, ensure patient access to medications, and amend existing contracts to maintain competitive discount terms to ensure favorable business outcomes. This role will also monitor key performance indicators (KPIs) and service level agreements (SLAs) to ensure vendor performance meets or exceeds expectations.

This position will be based out of our Berwyn, PA headquarters, with a minimum of 3 days in the office.

Join AscellaHealth- Where innovation Meets Patient Care

About the role

Critical parts of the job/Key Responsibilities

Strategy and Design

• Define the end-to-end strategy for each network composition: geography, coverage, access, channel optimization
• Develop and refresh value propositions of each channel and ensure alignment with business goals and customer needs
• Monitor industry trends, regulatory environment, and competitive landscape, and incorporate those insights into network design and pricing strategies

Financial Management and Performance

• Establish financial targets for network unit costs, cost trend, and reimbursement savings
• Budget, forecast, and manage network cost drivers
• Leverage analytics and insights to monitor network performance, identify cost containment opportunities, and create action plans

Vendor Management and Collaboration

• Organize, facilitate, and collaborate with Senior Leadership Teams and cross-functional workgroups to address vendor service-related initiatives, savings opportunities, and operational issues
• Regularly interface with network vendors to collaborate on initiatives, gather information, and lead troubleshooting and issue resolution efforts
• Research, identify, and establish relationships with new vendors as necessary to enhance network capabilities and service delivery
• Serve as the primary point of contact for vendor disputes, ensuring prompt and effective resolution
• Participate in Specialty Pharmacy business reviews, KPIs, and SLAs to strengthen vendor relationships and achieve measurable performance outcomes
• Set up Standard Operating Procedures (SOP's) that align with a best-in-class pharmacy network
• Represent the organization externally with network pharmacies

Contract Negotiations and Management

• Lead contract negotiations to secure competitive, best-in-class pricing discounts and terms
• Obtain and evaluate vendor proposals and contract enhancements through established procurement processes
• Facilitate completion of all documentation required to implement new agreements or amend existing ones, including credentialing standards
• Maintain organized records of all documentation, correspondence, and agreements between the organization and vendors
• Support the ongoing process of maintaining accurate contract and pricing data within internal systems and databases
• Lead audit strategy and vendor partnerships to manage and recover financial liability, ensure contract compliance, and maximize margins

Performance Monitoring and Reporting

• Collect and monitor vendor KPIs and SLAs to ensure adherence to operational and service expectations
• Facilitate data collection and aggregation related to member spend, product category usage, benchmarking, and pricing
• Continuously evaluate vendor performance and identify opportunities for improvement and cost savings

Strategic and Operational Support

• Collaborate with operational and strategic partners to evaluate vendor and network capabilities and develop initiatives that promote a best-in-class pharmacy network
• Contribute to strategic planning efforts that align vendor partnerships with the organization's short- and long-term goals

Skills, Education & Abilities

Essential Requirements

• Proven ability to lead large, complex contract negotiations, manage vendor agreements, and secure competitive terms and discounts in alignment with organizational goals
• Proven ability to manage multi-channel pharmacy networks with measurable outcomes in costs, access, and margin
• Strong analytical skills with demonstrated experience in evaluating claims data, performance metrics (KPI/SLA), and financial trends to support strategic decision-making
• Excellent interpersonal, communication, and presentation skills with the ability to build and maintain productive relationships across internal stakeholders and external vendor partners
• Proficient in using contract management, pricing, and data analysis systems; ability to manage multiple projects, meet deadlines, and maintain attention to detail in a fast-paced environment
• Strong financial acumen: able to interpret and act on pricing, margin, and performance data
• Deep understanding of pharmacy economics, pharmacy reimbursement methodologies (AWP-based, MAC, ASP, NADAC, etc.), claim adjudication, and network operations.
• Strong familiarity with regulatory standards for pharmacy networks – URAC, ACHC, 340B, and state pharmacy requirements a plus
• Skilled in negotiating vendor and pharmacy network contracts, securing competitive pricing, and managing ongoing agreements to ensure compliance and performance.
• Strong ability to interpret financial, operational, and claims data to identify trends, assess vendor performance, and support strategic planning.
• Effective in identifying root causes of vendor or operational issues, developing solutions, and resolving disputes in a timely and professional manner.
• Excellent written and verbal communication skills; able to collaborate effectively across departments, present findings to leadership, and represent the organization externally.
• Highly organized with the ability to manage multiple priorities, track deliverables, and meet deadlines in a dynamic environment.
• Competence in Microsoft Office Suite (Excel, Word, PowerPoint), contract management platforms, and data analytics tools used for vendor and performance management.

Qualifications

• A bachelor's degree in Pharmacy, Business Administration, Healthcare Management, or a related field is required
• A minimum of five (5) years of experience in pharmacy network management, managed care contracting, or vendor relationship management within the healthcare or payer industry

Preferred Qualifications

• Advanced degree preferred – MBA, MHA, or equivalent

Ready to make an impact? Join us on our mission to transform specialty pharmaceutical services and improve patient lives. We're looking for passionate professionals who share our commitment to excellence and innovation. Apply today and become part of a team that's shaping the future of healthcare.

About Us

AscellaHealth is a global Specialty Pharmaceutical and Healthcare services organization serving patients, payers, life sciences, and providers, offering a comprehensive portfolio of customized, tech-enabled specialty pharmaceutical and medical management services. An Inc. 5000 2023 winner, AscellaHealth's unique, patient-centric approach supports its strategic partnership with Optime Care and is built upon proprietary technology processes for innovative programs and services optimizing health outcomes and quality of life for patients with complex, chronic conditions or rare diseases that require specialty medications and/or gene and cell therapies.

Discover more about our mission, leadership team, and what makes us a great place to work by visiting -us

AscellaHealth provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.