Network & PBM Strategy Vice President

Pay scale information is not necessarily reflective of actual compensation that may be earned nor a promise of any specific pay for any selected candidate or employee which is always dependent on actual experience education qualifications and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems Inc. is looking for extraordinary people to join our team!

Why join MedImpact Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity high performance and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products systems and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction service cost and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Summary

The Network & PBM Strategy Vice President is a senior leader responsible for defining and executing enterprise network payer contracting underwriting and operational strategies across the PBM business. This role establishes vision sets priorities designs scalable governance and processes and allocates resources to achieve financial operational and growth objectives aligned with the parent organizations long term strategy.

Partnering closely with the sales and account management trade relations as well as executive leadership this position drives enterprise level planning payer and network strategy portfolio performance and market differentiation. The role has direct oversight of large chain pharmacy network contracting PBM Underwriting and will influence and drive successful client pricing strategy with accountability for PBM P&L performance operational excellence and brand growth across all payer segments.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Own departmental Profit & Loss (P&L) including revenue cost of goods sold (COGS) administrative expense management and margin optimization.

• Develop manage and forecast budgets; identify and execute strategies that drive sustainable profitability and scalable growth.

• Oversee advanced financial modeling scenario analysis and forecasting to support executive decisionmaking on client deals.

• Ensure pricing contracting and underwriting strategies align with financial targets risk tolerance and longterm client value.

• Establish and lead the payer and network contracting vision strategy and governance framework across all payer segments including commercial Medicare Medicaid and specialty markets.

• Oversee all networkrelated functions including Pharmacy Network Contracting Provider Contracting Account Management and Provider Data Management.

• Design and execute pharmacy and provider network strategies that optimize cost access quality and performance.

• Provide executive leadership for highstakes national and regional payer PBM and network negotiations including complex commercial Medicare Medicaid and specialty agreements.

• Lead the negotiation and execution of contracts with major retail mailorder specialty pharmacy networks and payer partners to ensure competitive pricing access and compliance.

• Champion innovative contracting approaches including valuebased outcomesbased and alternative reimbursement models.

• Build maintain and expand executivelevel relationships with senior payer PBM and network leadership to advance longterm strategic partnerships.

• Direct PBM underwriting strategy pricing governance and financial risk assessment activities.

• Ensure underwriting models accurately reflect utilization patterns rebate economics network costs reimbursement methodologies and administrative expenses.

• Balance profitability competitiveness transparency and client savings objectives across new business and renewals.

• Partner with peer leaders to lead strategic planning market analysis business mapping budgeting and goal setting.

• Anticipate and respond to regulatory legislative and reimbursement trends that materially impact payer economics access strategies and compliance obligations.

• Identify emerging market opportunities competitive threats and evolving payer dynamics within the PBM and broader healthcare ecosystem.

• Shape expand and commercialize payerfocused service offerings that differentiate the organization and drive revenue growth.

• Provide executive oversight of daytoday operations across all assigned departments ensuring consistency efficiency and scalability.

• Establish performance management analytics and reporting standards to ensure payer and network contract compliance optimization and transparency.

• Champion innovation through process improvement analytics enhancement automation and the development of proprietary tools and capabilities.

• Ensure compliance with all applicable federal state and industry laws regulations and contractual requirements.

• Partner with executive leaders across Legal Finance Clinical Operations and Consulting to ensure alignment governance discipline risk mitigation and contract integrity.

• Serve as an executive advisor to clients and internal leaders on payer strategy network design reimbursement optimization and market dynamics.

• Support strategic client engagements executive presentations and complex payer discussions.

• Represent the organization as a senior thought leader with clients partners and industry stakeholders.

Supervisory Responsibilities

Manages assigned staff in the segment area. Responsible for the overall direction coordination and evaluation of the unit. Carries out supervisory responsibilities in accordance with the organizations policies and applicable laws. Responsibilities include interviewing hiring and training employees; planning assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Supports and enforces all company policies and procedures in a fair and consistent manner taking corrective action whenever necessary.

Client Responsibilities

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Qualifications

To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

BA/BS degree or equivalent plus 10 years related experience and 8 years SME experience. If leadership is required 4 years supervisory experience preferred or approved MedImpact leadership alternative pathway.

Computer Skills

• Advanced skill set in MS Office Teams Word Excel PowerPoint Project and Outlook

Certificates Licenses Registrations

None required

Other Skills and Abilities

• Recognized Subject Matter Expert in Pharmacy Network and Payer Contracting within the PBM industry.

• Deep expertise in MAC pricing reimbursement models payer economics and network strategy.

• Proven success with full P&L accountability including revenue COGS and operating expense control.

• Advanced knowledge of PBM underwriting methodologies and financial modeling.

• Strong executive presence negotiation skills and ability to lead complex multi stakeholder initiatives.

• Proficiency in Microsoft Office Suite and data driven decision making tools.

Reasoning Ability

• Ability to define problems collect data establish facts and draw valid conclusions.

Mathematical Skills

• Ability to apply concepts such as fractions percentages ratios and proportions to practical situations.

Language Skills

• Ability to make effective and persuasive speeches and presentations on controversial or complex topics to top management public groups and/or boards of directors.

Competencies To perform the job successfully an individual should demonstrate the following competencies:

• Business Acumen

• Directing Others

• Organizational Agility

• Conflict Management

• Drive for Results

• Political Savvy

• Customer Focus

• Innovation Management

• Strategic Agility

• Decision Quality

• Managerial Courage

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger handle or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

This position may regularly be exposed to or encounter moving mechanical parts high precarious places fumes or airborne particles toxic or caustic chemicals outdoor weather conditions risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers light traffic).

Work Location

This position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees colleagues clients or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.

Working Hours

This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and reasonably meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights at weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm.

Travel

This position requires both domestic and international travel of up to 25% of the time. A valid passport and ability to leave the United States is required

• Medical / Dental / Vision / Wellness Programs

• Paid Time Off / Company Paid Holidays

• Incentive Compensation

• 401K with Company match

• Life and Disability Insurance

• Tuition Reimbursement

• Employee Referral Bonus

To explore all that MedImpact has to offer and the greatness you can bring to our teams please submit your resume to is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego California. Our solutions and services positively influence healthcare outcomes and expenditures improving the position of our clients in the market. MedImpact offers high-value solutions to payers providers and consumers of healthcare in the U.S. and foreign markets.

To perform this job successfully the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge skill and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities duties and skills required of personnel so classified.