Sr. Manager Managed Care Contracts

• Manages activities supporting Brand participation in Managed Care pharmacy provider networks including: solicitation of provider agreements review and proposal of contract language negotiation of reimbursement rates and contract management and retention.
• Negotiates on behalf of Brand pharmacies and aligned with Brand strategic plans and financial objectives for inclusion within payer networks including national regional and local broad and narrow networks sponsored by commercial or governmental payers.
• Provides financial analysis of solicitations and communicates to brands and provides as inputs to budgeting and forecasting processes.
• Manages relationship with switch Medicare/medical vendors and accrediting bodies overseeing team to create edits and communicate to brand operations.
• Provides oversight and support of pharmacy claims processing transactional analysis and contract performance management including analysis and reconciliation of effective rate contracting & DIR or performance rebate impacts as applicable.
• Builds and retains relationships with key payer network sponsors firms including health plans large employer groups Medicare Plan sponsors etc. Responsible for financial analysis and management guidance regarding new or adjusted payer network proposals including reimbursement rates contractual terms compliance standards and performance-based fees.
• Accountable for the execution and retention of all payer network agreements on behalf of Brand pharmacies. Primary point of pharmacy network sponsor contact on behalf of the Brands and responsible for the receipt review and response to inbound payer communication as well as network provider manuals.
• Additional job duties may be assigned as needed to meet the needs of the business and support our Values.

• Bachelor's Degree
• 3 + years financial services experience
• Relevant pharmacy industry experience

What We Do

Ahold Delhaize USA a division of global food retailer Ahold Delhaize is part of the U.S. family of brands which includes five leading omnichannel grocery brands – Food Lion Giant Food The GIANT Company Hannaford and Stop & Shop. Our associates support the brands with a wide range of services including Finance Legal Sustainability Commercial Digital and E-commerce Technology and more. Our team includes some of the best and brightest talent from a variety of backgrounds ranging from decades-long careers in retail to fresh perspectives from outside our industry. With a purpose-driven culture grounded in our values of courage care integrity teamwork and humor we are committed to fostering a culture of belonging where everyone is valued. Our team shares a common motivation to drive change take ownership and enable the brands we support to nourish their customers and communities. We thrive on supporting great local grocery brands and their strategies. As part of the largest grocery retail group on the East Coast we understand our vital role in enabling healthier people and a healthier planet and have an ongoing commitment to driving sustainable change that leads to a thriving food system nourishes local communities and creates a better world.

Why Work With Us

We love fresh perspectives not just fresh produce. We believe that an inclusive workplace fosters creativity accelerates innovation and helps us create an even better product. At Ahold Delhaize USA you’ll find coworkers who are caring and committed and who focus on dreaming big and getting things done.

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