Manager, Network Relations

What you’ll do

In a few words…               

 Abarca is igniting a revolution in healthcare.  We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning…

As our Manager for Network Relations, you will be responsible for managing the Company’s relations with all the pharmacies in the Provider Network and act as a primary contact for pharmacy service-related support topics. You will work to ensure our Provider Network agreements are being met as accorded and ensure that our pharmacy partners are satisfied with the level of attention and service provided by the Network Relations team. 

The fundamentals for the job… 

• Establish and maintain relationships with pharmacy chains and PSAOs, as well as national pharmacy organizations, i.e., NCPDP. 
• Serve as primary point of contact for pharmacy contract and operational questions. 
• Work with Legal teams on creating and revising pharmacy contracting documents and credentialing requirements. 
• Support the development, maintenance, and execution of Rx Programs, operationalize tasks associated, and deliver the highest quality of service to clients and pharmacies. 
• Support the day-to-day tasks related to Rx Programs, including triaging, and resolving issues, answering requests, delivering reports on demand, and identifying opportunities for improvement. 
• Align with Pharmacy Training teams on network education and other outreach initiatives. 
• Provide support to Client Engagement and Audit teams in Network related items such as directories, pharmacy education, member’s grievances, URAC certification, etc. 
• Support Operations in the setup configuration and maintenance of pharmacy network requirements. 
• Work with Clinical, Finance, Service Operations, Product and Development teams to enhance the pharmacy experience in the Operational Portal by adding self service and automated processes that support operational efficiency.
• Ensure proper storage and retention of all pharmacy documentation.
• Strong understanding of NCPDP pharmacy and telecommunications data.

What you’re made of

The bold requirements…

• Bachelor’s Degree or Master’s Degree in Pharmacy, Business, Mathematics, or a related field (In lieu of a degree, equivalent relevant work experience may be considered.) 
• 6+ years of experience in a similar role within a PBM or Healthcare
• Experience in pharmacy benefit management including Federal and State regulations related to networks
• Experience with provider contract terms in PBM or related industry 
• Experience in PBM client LOB:  Commercial, Employer Groups, Health Plans, Medicare Part D, Medicaid, 340B, Discount Card 
• Experience in Pharmacy LOB:  Retail, Long Term Care, Home Infusion, Mail Order, Specialty, Institutions.
• Excellent oral and written communication skills
• We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only)
• This position requires availability to work in a specified time zone or working schedule, accommodating the business needs of our clients and team members.
• This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable).
• Candidate must be located in Puerto Rico

Nice to have… 

• Experience in a Provider Relations, Chain Pharmacy, PSAO, Client Service, or a Relationship Management

Physical requirements…

• Must be able to access and navigate each department at the organization’s facilities.
• Sedentary work that primarily involves sitting/standing.

At Abarca we value and celebrate diversity. Diversity, equity, inclusion, and belonging are guiding principles of Abarca and ensure Abarca’s workforce reflects the communities it serves.  We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

 Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify.  “Abarca Health LLC does not sponsor employment visas at this time”

 The above description is not intended to limit the scope of the job or to exclude other duties not mentioned. It is not a final set of specifications for the position. It’s simply meant to give readers an idea of what the role entails.

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