Overview

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The new Account Executive for Managed Care position will be responsible for all Pharmacy Benefit Manager (PBM) contracts across IU Health mainly in the retail/specialty pharmacy space. This role will work in collaboration with Pharmacy Services, Payer Contracting, Finance, Legal, and others. Will support the development and execution of contracting (including renewal) strategy, adhering to departmental pricing policy and preferred contract terms.

Possesses a strong and increasing working knowledge of the contracting process between IU Health payers, pharmacy benefit managers, suppliers, and pharmaceutical companies, and acts as a subject matter expert and resource to others. Acts as a lead in contract negotiations and on all pharmacy accounts and effectively and skillfully represents IU Health pharmacy services to finalize favorable contracts for the organization and department. Effectively balances demands of multiple accounts to ensure timeliness, contract compliance and performance results. Demonstrates a solid and strong working knowledge of pharmacy payment methodologies for commercial and government payers and ensures that department processes are aligned with such programs. Maintains a current understanding of contracting issues and takes efforts to keep current in industry intelligence. Monitors and identifies potential issues with managed care payers. Supports the organization in understanding potential impacts to ensure appropriate issue resolution.

Demonstrates a skilled understanding of commercial insurance, particularly for the specific benefit plan designs, payment structures, and insurance offerings represented by assigned payers and incorporates that knowledge into those contracts in order to ensure effectiveness.