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SmithRx
Legal & HR 1h ago

Vice President of Pharmacy Networks

SmithRx
United StatesUnited States
Full-time
$238,000 — $280,000 USD
Lead/Manager

Job Description

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What you will do:

Network Strategy & Contracting

  • Lead Network Strategy: Design and execute the overarching strategy for SmithRx’s national and custom pharmacy networks, ensuring alignment with our transparent business model and client needs.
  • Contract Negotiation: Lead high-level negotiations with major retail chains, PSAOs, specialty pharmacies, and mail-order partners to secure competitive reimbursement rates and favorable contract terms without relying on spread pricing.
  • Strategic Partnerships: Identify and develop innovative network programs (e.g., high-performance or narrow networks, direct-to-consumer delivery models) to drive down drug costs and improve member access.

Network Management & Operations

  • Oversee Network Performance: Monitor and manage the ongoing performance of the pharmacy network against defined SLAs, ensuring adherence to contractual terms, quality standards, and pricing accuracy.
  • Credentialing & Compliance: Direct the credentialing and re-credentialing processes, ensuring all network pharmacies comply with federal, state, and SmithRx regulatory standards.
  • Audit & Fraud Prevention: Oversee the pharmacy audit team to manage network integrity, minimize Fraud, Waste, and Abuse (FWA), and execute audit recoveries effectively.
  • Government programs readiness: Implementation of needed policies and procedures to meet CMS oversight requirements.

Cross-Functional Leadership

    • Internal Alignment: Partner closely with Sales, Customer Success, Clinical Strategy, Pricing/Underwriting, and Product teams to ensure network capabilities are accurately represented in the market and successfully integrated into our technology platforms.
    • Data & Analytics: Collaborate with data and analytics teams to monitor network profitability, utilization trends, and cost models to proactively identify areas for financial optimization.
    • Team Development: Build, mentor, and scale a high-performing team of network managers, contracting specialists, and analysts. Foster a culture of accountability, integrity, and courage

What you will bring to SmithRx:

  • Experience: 12+ years of progressive leadership experience in pharmacy network management, pharmacy contracting, or PBM operations.
  • Experience across lines of business: Commercial, Medicare, Medicaid, Exchange
  • Industry Expertise: Deep understanding of the PBM ecosystem, pharmacy reimbursement models (AWP, MAC, NADAC), and the operational differences between traditional and pass-through/transparent PBMs.
  • Negotiation Skills: Proven track record of successfully negotiating complex, multi-million dollar contracts with major national pharmacy chains and PSAOs.
  • Leadership: Demonstrated experience building, leading, and mentoring cross-functional and remote teams in a high-growth environment.
  • Analytical Acumen: Strong financial and analytical skills with the ability to understand complex pricing models and translate data into actionable network strategies.
  • Education: Bachelor’s degree in Business, Healthcare Administration, Finance, or a related field; PharmD or Master’s degree (MBA/MHA) is highly preferred.

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SmithRx is a healthcare technology company that specializes in pharmacy benefits management and medication access solutions. With a focus on improving patient outcomes and reducing healthcare costs, SmithRx offers a range of services designed to simplify the prescription medication process for patients, pharmacies, and healthcare providers. The company's innovative approach to pharmacy benefits management combines advanced technology, data analytics, and clinical expertise to optimize medication therapy and enhance the overall patient experience. By streamlining the prescription process, reducing costs, and improving medication adherence, SmithRx aims to make a positive impact on the lives of patients and the healthcare system as a whole.

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