Pharmacy Contract Specialist
Pharmacy Contract Specialist
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Job Description
Job Details
If you have experience with retail mail-order or specialty pharmacy this is the job for you!
ChristianaCare is one of the countrys most dynamic healthcare organizations centered on improving health outcomes making high-quality care more accessible and lowering healthcare costs. ChristianaCare includes an extensive network of outpatient services home health care urgent care centers three hospitals (1299 beds) a free-standing emergency department a Level I trauma center and a Level III neonatal intensive care unit a comprehensive stroke center and regional centers of excellence in heart and vascular care cancer care and womens health. It also includes the pioneering Gene Editing Institute and was rated by IDG Computerworld as one of the nations Best Places to Work in IT. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. It is continually ranked by U.S. News & World Report as the Best Hospital. With the unique CareVio data-powered care coordination service and a focus on population health and value-based care ChristianaCare is shaping the future of health care.
ChristianaCare Offers
- Full Medical Dental Vision Life Insurance etc.
- Two retirement planning offerings including 403(b) with company contributions
- Generous paid time off with annual roll-over and opportunities to cash out
- 12-week paid parental leave
- Incredible Work/Life benefits including annual membership to access to backup care services for dependents through retirement planning services financial coaching fitness and wellness reimbursement and great discounts through several vendors for hotels rental cars theme parks shows sporting events movie tickets and much more!
About this Position
ChristianaCare is searching for a Pharmacy Contract Specialist for the Specialty Pharmacy program and will focus on internal and external payer relationships and will establish develop and maintain relationships with current and prospective payers that nurture payer partnerships to support the Specialty Pharmacy program strategy. This role needs to understand the interrelationships and competitive landscape of the payers in the markets and will also provide support to Pharmacy Leadership for pharmacy credentialing and licensing and market access to limited distribution drugs (LDDs).
PLEASE NOTE - this position has a specialty pharmacy focus that also supports retail and mail order pharmacy
Principal duties and responsibilities:
Maintains and updates Pharmacy Services contracts for outpatient pharmacy sites including retail mail order and specialty pharmacy. Informs stakeholders of changes and responds to questions/concerns.
Provides business analytics and decision support for key sourcing activities and provides ongoing spend / value reporting.
Acts as a subject matter expert in the requirements rules and regulations of third-party and government payers. Understands eligibility requirements and authorization requirements of insurance company plans Medicare Medicaid and how each program/payer reimburses.
Reconciles post-award execution such as price challenges auditing quality concerns Accounts
Payable and Accounts Receivable issues rebate payments from vendors and answers general questions from customers and vendors.
Is a relevant thought leader and active contributor to the business by maintaining a strong knowledge of pharmacy contracting supplier capabilities market trends and technological advances in all aspects of pharmaceutical contracting including manufacturing wholesaler 340b and GPO contract structures.
Collaborates on the development and optimization of key sourcing and cost management tools and systems.
Recommends Pharmacy Services policies and procedures related to third-party contracts/agreements.
Reviews of both simple and sophisticated contracting opportunities for cost savings.
Supervises and manages the business process of contract execution in collaboration with the Legal department.
Engages our Legal & Risk Management team in the development of contract templates and serve as a subject matter expert on the execution of these contracts.
Maintains a working familiarity with and consults on regional and cross-border regulatory and compliance issues as it impacts participating provider contracts and practice operations across Delaware Maryland Pennsylvania and New Jersey.
Is adaptive and able to perform multiple roles leader consultant advisor depending upon the nature and scope of the project.
Conducts performance and payment audits to ensure adherence to contract accreditation and regulatory requirements.
Investigates denials and coordinates appeals. Recommends changes to procedures to prevent denials.
Monitors key metrics for the Pharmacy Services Performance Improvement Committee and pharmacy leadership.
Monitor Specialty Pharmacy purchases for contract compliance and accurate pricing.
Review contract compliance and identify savings opportunities and relay those to pharmacy management to facilitate decision making.
Collaborate with the 340b team to identify cost savings opportunities.
Assists in obtaining and maintaining pharmacy credentialing and licensure access to limited distribution drugs (LDDs) and enrollment in Risk Evaluation and Mitigation Strategies (REMS) drugs.
*********The full job specification will be provided during the recruitment process.
Education and experience requirements:
- Bachelors degree required (focus in business health care or accounting preferred)
- Masters degree in business administration healthcare administration or contracting preferred
- Experience in retail mail order or specialty pharmacy required
- Experience with third-party negotiations preferred
- Experience with pharmacy supply chain preferred
- Familiarity with health system and/or pharmacy revenue cycle preferred
Post End Date
Aug 25 2025EEO Posting Statement
Christiana Care Health System is an equal opportunity employer firmly committed to prohibiting discrimination whose staff is reflective of its community and considers qualified applicants for open positions without regard to race color sex religion national origin sexual orientation genetic information gender identity or expression age veteran status disability pregnancy citizenship status or any other characteristic protected under applicable federal state or local law.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
