Director, Contract Strategy & Provider Engmt
About The Position
Due to growth, we are adding a Director, Contract Strategy & Provider Engagement to our team! The Director, Contract Strategy & Provider Engagement is responsible for leading the strategic oversight, governance, and provider‑facing execution of pharmacy network contracting frameworks. This role focuses on contract strategy, provider engagement, and enterprise‑level alignment, ensuring that pharmacy participation agreements are structured, interpreted, and applied in a manner that supports network pricing strategy, quality objectives, regulatory compliance, and long‑term provider relationships. The Director serves as a strategic liaison between Network Contracting, providers, and internal stakeholders, providing direction on contract interpretation, amendment strategy, and provider engagement, while delegating routine transactional issue resolution and day‑to‑day operational support to downstream teams. Unlike purely operational contract administration roles, this position plays a critical role in shaping contract standards, engagement models, and governance practices, supporting scalable growth and consistency across the pharmacy network.
Requirements
- Bachelor’s degree in Business, Finance, Economics, or Healthcare Administration, or related field, or equivalent work experience, required.
- 7+ years of progressive PBM, healthcare plan, pharmacy network, or equivalent experience required.
- Demonstrated experience in provider contracting, contract strategy, or network governance required.
- Strong understanding of pharmacy reimbursement and claims adjudication concepts required.
- 3+ years of leadership experience with a proven ability to develop high-performing teams and deliver tangible results in a professional services environment required.
- Participate in, adhere to, and support compliance program objectives.
- The ability to consistently interact cooperatively and respectfully with other employees.
Responsibilities
- Provide strategic leadership over pharmacy participation agreements, network addenda, and contract standards, ensuring consistency with enterprise pricing, quality, and access strategies.
- Develop and maintain contracting playbooks, standards, and governance frameworks to guide negotiations, amendments, and operational application.
- Partner with Legal, Compliance, and Network Pricing leadership to ensure contract structures align with regulatory requirements and enterprise objectives.
- Support strategic contract amendments, renewals, and enhancements, focusing on intent, scalability, and long‑term impact, rather than transactional execution.
- Serve as a senior point of engagement for pharmacy providers, chains, and affiliations on contract‑related matters.
- Maintain productive, professional relationships with providers to support alignment, transparency, and issue prevention.
- Lead provider discussions related to contract interpretation, structural changes, and strategic alignment, escalating only high‑impact or systemic issues.
- Partner with Provider Services and Network Leadership to ensure consistent provider messaging and engagement models.
- Provide strategic guidance on contract interpretation to support pricing strategy, claims configuration, and network governance.
- Act as an escalation point for complex, high‑risk, or systemic contract issues, while ensuring routine transaction‑level issues are handled operationally.
- Analyze trends in provider inquiries or disputes to identify structural contract or process improvement opportunities.
- Recommend contract language, governance, or system changes to reduce recurring operational friction.
- Support Sales and Client Services by providing strategic clarity on contract constructs and network positioning.
- Participate in company initiatives related to network strategy, growth, and regulatory readiness.
- Provide leadership and direction to contract strategy, governance, or senior contract staff, as applicable.
- Set expectations for quality, consistency, documentation, and escalation discipline.
- Other duties as assigned.
Benefits
- Health, Dental, and Vision insurance
- 20 days paid time off
- 4 weeks paid parental leave
- 9 paid holidays
- 401K company match of up to 5%
- Adoption Assistance Program
- Flexible Spending Account
- Educational Assistance Plan and Professional Membership assistance
- Referral Bonus Program – up to $750!
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What This Job Offers
Job Type
Full-time
Career Level
Director
