Vice President, Payer Solutions

7,000 Diseases - 500 Treatments - 1 Rare Pharmacy

PANTHERx is the nation’s largest rare disease pharmacy, and we put the patient experience at the top of everything that we do.

If you are looking for a career in the healthcare field that embraces authentic dedication to patient care, you don’t need to look beyond PANTHERx. In every line of service, in every position and area of expertise, PANTHERx associates are driven to provide the highest quality outcomes for our patients.

We are seeking team members who:

Are inspired and compassionate problem solvers;

Produce high quality work;

Thrive in the excitement of the ever-challenging environment of modern medicine; and

Are committed to achieving superior health outcomes for people living with rare and devastating diseases.

At PANTHERx, we know our employees are the driving force in what we do. We cultivate talent and encourage growth within PANTHERx so that our associates can continue to explore their interests and expand their careers. Guided by our mission to provide uncompromising quality every day, we continue our strategic growth to further reach those affected by rare diseases.

Join the PANTHERx team, and define your own RxARE future in healthcare!

Department: Administration

Location: Remote

Job Classification: Exempt

Job Status: Full-time

Reports to: Chief Strategy and Growth Officer

Purpose:

The Vice President, Payer Solutions leads all payer contracting and relationship efforts that align reimbursement and business strategies to ensure PANTHERx's differential position in the marketplace is leveraged. This role collaborates closely with the Chief Legal Office and Revenue Cycle Management leadership and develops and maintains strong anf sustained relationships with PBM and health plan payers which assure fair reimbursement for medications and services.

The successful candidate will have numerous and deep relationships within the payer community and have broad and deep industry knowledge within the pharmacy ecosystem.

Responsibilities:

• Leads the development and implementation of a payer strategy for PANTHERx to drive revenue enhancement through contracting and partnerships with payers, capitalizing on the unique rare disease portfolio and value proposition of PANTHERx.
• Maintains relationships with key personnel at the payer organizations representing over 90% of the revenue at PANTHERx. This will include commercial (PBMs and Health Plans), Medicare, Medicaid, and Federal Health Insurance.
• Leads the strategic direction and administrative oversight of contract negotiations with payers, including re-negotiations as contracts expire.
• Executes contract addendums as PANTHERx adds exclusive and highly limited distribution drugs to our portfolio, minimizing any negative margin dispenses at launch.
• Establishes payer contracting goals and strategies, negotiating and supporting all contracts with payers, and maintaining oversight of payer manual changes to ensure compliance.
• Collaborates with the Contracting team to ensure payer compliance with contract terms and payment rates, utilizing payer contacts to reverse underpayments soon after they occur.
• Seeks opportunities for PANTHERx to engage in rare disease management opportunities with payers that provide opportunities to maximize revenue growth.
• Effectively utilizes Board members and external consultants to maximize the payer contracting efforts.
• Uses data and analytics to make data-driven decisions to improve the performance of the payer contracts.
  
  

Required Qualifications & Business Experience:

• B.A. or B.S. in business, economics, product marketing, pharmacy, or a related subject. Advanced degree preferred.
• Minimum of 10 years working directly with payer contracting and administration.
• Experience with negotiating, reviewing, and implementing payer contracts.
• Experience in business strategy discussions.
• Well-developed negotiation skills.
• Decision making skills that support organizational success.
• Excellent communication and collaboration skills.
• Ability to build consensus and relationships among executives, partners, and employees.
  
  

Work Environment:

This job operates in a professional home office or office environment. When in-office this role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines, and communications via MS Teams.

Physical Demands:

While performing the duties of this job, the employee is regularly required to talk or listen. The employee frequently is required to sit; stand, walk; use hands and fingers, handle or feel; and reach with hands and arms and see a computer screen. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function of the job.

Benefits:

Hybrid, remote and flexible on-site work schedules are available, based on the position. PANTHERx Rare Pharmacy also affords an excellent benefit package, including but not limited to medical, dental, vision, health savings and flexible spending accounts, 401K with employer matching, employer-paid life insurance and short/long term disability coverage, and an Employee Assistance Program! Generous paid time off is also available to all full-time employees, as well as limited paid time off for part-time employees. Of course we offer paid holidays too!

Equal Opportunity:

PANTHERx Rare Pharmacy is an equal opportunity employer, and does not discriminate in recruiting, hiring, promotions or any term or condition of employment based on race, age, religion, gender, ethnicity, sexual orientation, gender identity, disability, protected veteran's status, or any other characteristic protected by federal, state or local laws.