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Independent Health

Nonprofit health insurance for Western New York

PBM Contract Manager

Full-Time
$70k - $85k/yr+ Scorecard incentive
Senior
Bachelor's
Williamsville, NY, USA
HybridOnsite attendance is required at the Williamsville location.
Contract Management
No H1B Sponsorship

About the job

Requirements
  • A bachelor's degree is required, or four additional years of experience may be accepted in lieu of the degree.
  • Five years of experience in corporate/vendor contract management and negotiations, regulatory and/or compliance research and monitoring is required.
  • Strong analytical, problem-solving, time-management, and organizational skills are required.
  • Ability to work independently and manage multiple projects in a fast-paced, fluid environment is required.
  • Advanced computer and Windows skills are required, along with experience using Microsoft Office applications and the ability to learn new software applications.
Responsibilities
  • Oversee and manage client, vendor, and other business contracts and agreements, ensuring PBD’s business needs and interests are represented.
  • Draft, review, negotiate, and facilitate the execution of new and existing contracts and agreements.
  • Act as liaison between PBD business units, the Independent Health legal department, outside legal counsel, and vendors.
  • Conduct state and federal regulatory research and monitoring, and prepare, file, and manage business registrations and licensures.
  • Create and maintain tracking and monitoring processes, policies and procedures, performance and reporting requirements, and communicate metrics to key stakeholders.
  • Research and define business needs that support review, negotiation, and execution of registrations, licenses, agreements, and contracts.
  • Monitor state and federal PBM regulations and business requirements for changes or updates.
  • Research PBM application and regulatory requirements for obtaining and maintaining licenses or business registrations in states where PBD plans to operate.
  • Complete and facilitate documentation and applications for timely initial and renewal license or registration submissions.
  • Develop and maintain tracking processes to support compliance with business operations, application, and renewal requirements.
  • Facilitate and oversee contracting for requests for proposals, Administrative Service Agreements, amendments, vendor agreements, rebate contracts, pharmacy and network contracts, and software licenses.
  • Draft, review, edit, negotiate, and facilitate execution of agreements and contracts.
  • Develop and maintain processes to monitor compliance with contract terms and conditions.
  • Facilitate timely review and renewal of contracts.
  • Create and maintain process and duty performance metrics, tracking, and reporting.
  • Create and maintain policies, procedures, and documentation supporting PBD processes and duties.
  • Communicate needs, status, and overall performance metrics to key stakeholders.
Desired Qualifications
  • A Paralegal Studies degree is preferred.
  • Experience with self-funded group health plans is preferred.

About the company

Independent Health is a nonprofit health plan serving individuals, families and employers in Western New York. It sells commercial coverage and Medicare Advantage plans, while helping employers that pay their own workers' medical claims administer their benefits. Its network of physicians and other providers connects members with medical care, and its programs emphasize prevention and support for managing health conditions. The family of companies also includes health benefit administrator Nova Healthcare Administrators, pharmacy benefit manager Pharmacy Benefit Dimensions and specialty pharmacy Reliance Rx. Independent Health began operating in 1980 and is headquartered in Buffalo, New York.

Company Size

1,001-5,000

Company Stage

N/A

Total Funding

N/A

Headquarters

Buffalo, NY

Founded

1980

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