Senior Manager, Pharmacy Network - Payer

What we are looking for

AscellaHealth is seeking a Senior Manager, Pharmacy Network for its Berwyn, PA office. The Senior Pharmacy Network Manager will lead and execute the strategic, operational, and financial management of the organization’s pharmacy networks, including retail, specialty, mail order, and home infusion.  They 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.

In partnership with leadership, the Pharmacy Network Manager will contribute to the strategic planning and operational direction of the Pharmacy Network, developing initiatives that support both short- and long-term organizational objectives.

This is a high-impact individual contributor role where you’ll have the autonomy to focus on delivering results and shaping outcomes without the administrative responsibilities of managing a team.

This role will be hybrid, based at our AscellaHealth headquarters in Berwyn, PA, and will be required in the office three days a week.

What the position will be doing

• Define the end-to-end strategy for each network composition: geography, coverage, access, channel optimization
• Develop and refresh the value propositions of each channel and ensure alignment with business goals and customer needs
• Establish financial targets for network unit costs, cost trend, and reimbursement savings
• Responsible for budgeting, forecasting, and managing network cost drivers.
• Leverage analytics and insights to monitor network performance, identify cost containment opportunities, and create action plans
• Organize, facilitate, and collaborate with Senior Leadership Teams, as well as 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 to strengthen vendor relationships and achieve measurable performance outcomes.
• Represent the organization externally with network pharmacies.
• Lead all contract negotiations to secure competitive, best-in-class pricing and discount terms.
• Obtain and evaluate proposals and contract enhancements from vendors 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 protect margins.
• Collect and monitor vendor Key Performance Indicators (KPIs) and Service Level Agreements (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 or cost savings.
• 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.
• Perform other related duties as assigned or as necessary; remain flexible and adaptable in work schedules and work assignments as defined by departmental and organizational needs.

Necessary Skills, Education & Abilities

• Bachelor’s degree, or 4-year equivalent, in pharmacy, Business Administration, Healthcare Management, or a related field is required
• Advanced degree preferred – MBA, MHA, or equivalent
• Minimum of 5 years of experience in pharmacy network management, managed care contracting, or vendor relationship management within the healthcare or payer industry.
• Pharmacy Benefits Management (PBM) experience is a plus.
• Proven ability to lead extensive, 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), claim adjudication, and network operations.
• Strong familiarity with regulatory standards for pharmacy networks – URAC, ACHC, 340B, state pharmacy requirements a plus.
• Relentless attention to detail, and the ability to be a creative self-starter and team player.
• Passionate and curious person who looks to learn continuously and embraces the adoption of new technologies that impact business, markets, and user experiences.
• Strong interpersonal skills and the ability to work both independently and in a team setting effectively.
• Problem-solving mindset with the ability to de-escalate issues and find solutions quickly and effectively.
• Strong business skills and demonstrated ability to build solid working relationships with teammates, business leaders, and stakeholders while exhibiting genuine care.
• Transparent and persuasive communication and presentation skills.
• Ability to thrive in an environment with constantly changing and potentially competing priorities.
• Ability to think and act independently, formulate, and support new ideas, champion new initiatives within and beyond the scope of own responsibilities.
• Proficient in Microsoft Office Suite, especially Excel, Word, and Outlook.

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.

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.