Pharmacy Contract Specialist

Job Requisition #: JR60172

End Date: 12/4/2021

Location: Newark, Delaware

Position Type: Professional

Shift: Day Shift, No Rotation

Apply Now

ChristianaCare is seeking a Pharmacy Contract Specialist to conduct and coordinate the day-to-day contracting activities for Pharmacy Services in collaboration with the Managed Care Contracting Department. This position will be responsible for enhancing revenue by developing and maintaining significant contracts with third-party payors, primarily Managed Care Organizations (Blue Cross and Blue Shield, Aetna, Coventry, etc.) in accordance with CCHS policies.

The Pharmacy Contract Specialist will also work closely with key partners across the organization to coordinate and facilitate execution of pharmaceutical contracts for Pharmacy Services. This includes contracts for specialty pharmacy, our retail pharmacies, and employee Mail Order pharmacy. This position will also maintain and analyze information vital to the proper classification, evaluation, and quality of successful contracts focusing on brand, generic, and specialty medications. The Specialist will also promote successful contract performance by preventing and resolving problems and participate in the pharmacy supply chain sourcing team's strategic planning, preparation, and reporting.

A secondary function is to provide oversight and supervision of the business process of contracts processed through the legal department.

The ChristianaCare Way!

When you become an employee at ChristianaCare, you are joining a healthcare organization that was named Forbes 5th Best Health System to Work for in the U.S. for 2021! Guided by excellence and love, our Caregivers enjoy many employee benefits such as

Principal duties and responsibilities:

Maintains and updates Pharmacy Services contracts for both specialty and retail pharmacy. Informs stakeholders of changes and responds to questions/concerns

Provides business analytics and decision support for key sourcing activities and provides ongoing spend / value reporting

Work in collaboration with members of the managed care team to evaluate value based contracts that cross inpatient, outpatient and specialty operations lines

Acts as a subject matter authority in the requirements, rules and regulations of third-party and government payers. Understands eligibility requirements and authorization requirements of insurance company plans, Medicare, Medicaid, and how each program/payer reimburses

Reconciles post-award execution such as price challenges, auditing, quality concerns, Accounts Payable issues, rebate payments from vendors, answers general questions from customers and vendors

Is a relevant leader with vision and active contributor to the business by maintaining a solid understanding of pharmacy contracting, supplier capabilities, market trends, and technological advances in all aspects of pharmaceutical contracting including manufacturing, wholesaler, 340B and GPO contract structures

Collaborates on the development and optimization of key sourcing and cost management tools and systems

Recommends Pharmacy Services policies and procedures related to third-party contracts/agreements

Reviews both simple and sophisticated contracting opportunities for cost savings or clinical improvements

Supervises and leads the business process of contract execution in collaboration with the legal department

Partners with finance and decision support teams to build and maintain analytic models that enable the development and evaluation of various value-based models in new and existing markets

Engages our Legal & Risk Management team in the development of contract templates and serves as a subject matter expert on the execution of these contracts. Has a working familiarity with and consults on regional and cross-border regulatory and compliance issues, as it impacts participating provider contracts and practice operations across Delaware, Maryland, Pennsylvania, and New Jersey

Is adaptive and able to perform multiple roles - leader, consultant, advisor - depending upon the nature and scope of the project

Conducts performance and payment audits to ensure adherence to accreditation and regulatory requirements

Investigates denials and coordinates appeals. Recommends changes to procedures to prevent denials

Supervises key metrics for the Pharmacy Services PI committee and pharmacy leadership

Education and experience requirements:

  • Minimum 3 years background / experience in retail, specialty or hospital pharmacy required
  • Bachelor's degree required (focus in business, healthcare, or accounting preferred)
  • Master's in business administration, healthcare administration or contracting preferred
  • Minimum 3 years' experience with third-party negotiations required
  • Familiarity with health system revenue cycle required
  • Minimum 3 years' experience in Pharmacy Supply Chain required

EEO Statement: Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.


UPDATE: ChristianaCare is committed to prioritizing the health and safety of our patients and caregivers. As we continue to meet the needs of our caregivers and our community through the COVID-19 pandemic, our commitment to health and safety requires that we take new steps to ensure a safe environment for medical care for our patients and a workplace that avoids preventable harm for our caregivers. For this reason, vaccination for COVID-19 is required for all caregivers at ChristianaCare and is considered a safety standard that is job-related and consistent with business necessity for all caregivers.

Why do WE offer careers full of possibilities?

For the Love of Health.

Inclusion & Diversity

At ChristianaCare, we’re committed to treating everyone with dignity and respect. We believe in a safe, inclusive work environment that fosters collaboration between caregivers from all walks of life. We know that each unique viewpoint is vital in delivering high-quality, safe patient care to everyone who walks through our doors. Our policies, benefits, hiring practices, employee resource groups, and corporate citizenship demonstrate our commitment to inclusion and diversity throughout our system.

Why do we embrace inclusion and diversity? For the Love of Health.

Our Values

We serve together in Love and Excellence. Our unique values, Love and Excellence are bold and powerful, and they are the reason why working for ChristianaCare is special. The behaviors associated with our values guide how caregivers interact with everyone they work with and make for an exceptional work experience. We believe that when you lead with Love, Excellence is inevitable.

Benefits

ChristianaCare’s comprehensive total rewards package is one of the most competitive in the region. We are proud to offer excellent benefits that reflect the organization’s commitment to being exceptional today and even better tomorrow.

At ChristianaCare, we provide access to high-quality and affordable benefits designed to meet our caregivers where they are. You can tailor your benefits to meet your needs now and adjust them as your priorities change.

Take advantage of ChristianaCare’s wide-ranging benefit offerings from supporting optimal health through medical, prescription, dental and vision coverage to valuable wellness and work/life programs, which include paid parental leave, coverage for infertility and assisted reproductive technologies, an employer-funded short-term disability program, and more.

Delaware Photo
Our Region

A Great Place To Live

Our region offers a diversity of cultures, lifestyles, sports and entertainment events, housing options and educational opportunities. Located between Philadelphia and Washington, D.C., our locations provide easy access to two international airports, employment opportunities in a tri-state area, and proximity to some of the nation's top universities and colleges, as well as beaches in MD, DE and NJ!

Why Delaware? Why Maryland?
Flower

We Serve Together

For the Love of Health

Apply Now