Job Description

Acts as a senior member of the strategic function by contributing to the achievement of pharmacy affordability goals through specialty pharmacy network design, contracting strategy, network optimization, and innovative market-based pricing approaches. Leverages industry experience and expertise to evaluate emerging market opportunities, develop and implement network-based cost reduction strategies, and promote enterprise understanding of specialty pharmacy market dynamics to create sustainable competitive advantage and long-term affordability improvements.

• Proactively identify, analyze, evaluate, and implement specialty pharmacy network strategies, reimbursement models, and contracting opportunities that support affordability goals while maintaining member access, provider relationships, and regulatory compliance.
• Develop and execute specialty pharmacy network optimization strategies, including network design, performance management, pricing approaches, participation requirements, and market-based reimbursement methodologies.
• Support strategic planning, structured financial and qualitative analysis, business case development, and network evaluations to inform contracting decisions, network investments, and affordability initiatives.
• Translate complex network, reimbursement, and market dynamics into clear strategic recommendations and actionable plans for internal stakeholders, including senior leadership.
• Present network strategies, performance metrics, affordability opportunities, contracting recommendations, and impact assessments to internal audiences at all levels, including executive leadership.
• Collaborate with and support other departments across the enterprise on both common initiatives and unique ventures, acting as a subject matter expert in specialty pharmacy network strategy, contracting, reimbursement methodologies, and affordability solutions.
• Identify, analyze, and monitor industry, regulatory, technology, provider, PBM, and market trends that influence specialty pharmacy network performance, reimbursement economics, access models, and overall cost management.
• Engage with specialty pharmacies, PBMs, vendor, consultants, vendors, providers, and other external partners to evaluate opportunities, resolve strategic challenges, and support development of innovative affordability solutions.
• Organize, synthesize, and communicate progress, recommendations, and outcomes across the specialty pharmacy network strategy portfolio to support alignment, accountability, and informed decision-making.
• Utilize expertise to advance network strategy, contracting, reimbursement, and affordability capabilities, continuously improving how network-based solutions are developed, evaluated, and implemented to achieve sustainable unit cost reduction.