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Manager, Provider Relations

Department: Finance
Location: New York, NY

Location: Remote (For Non-Local) or Hybrid (Local to NYC area)

Position Summary:

The Manager, Provider Relations is tasked with (i) assisting with the contracting, relationship development and maintenance with a designated group of pharmacy providers including chain pharmacies and independent pharmacies, (ii) assist with contract management and communication, and (iii) assist with RFP and licenses responses.

Position Responsibilities:

  • Assist with the relationship development, contracting and maintenance with a designated group of pharmacy providers including chain pharmacies and independent pharmacies; such duties may include direct pharmacy relationship management, contract routing and dissemination, contract redline review and negotiation, standard contract and amendment creation.
  • Leads the pharmacy contract management process which includes developing any applicable process documents and resources as well as working with other teams to enhance the processes and resources already in place.
  • Oversees and maintains the pharmacy network communications process.
  • Manages other Provider Relations team members.
  • Provides subject matter expertise on request for proposal questions and licensure responses as well as industry information as needed to other departments.
  • Assists with projects related to custom contracting including contract and amendment development and tracking.
  • Assists with overseeing Health Plan relationships related to Provider Relations.
  • Works closely with the Director, Provider Relations to execute on the departmental and organizational goals.
  • Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

Required Qualifications:

  • Bachelor’s degree required.
  • 6+ years of PBM experience in provider/network relations, contracting or other relevant experience.
  • Ability to review contract terms, pricing and related documentation.
  • Proven track record of developing and maintaining client/account relationships and networks.
  • Strong communication skills with the ability to develop effective working relationships with providers and internal and external stakeholders.

Base Salary: $75,000 - $85,000

Nothing in this position description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

About Capital Rx

Capital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advancing our nation’s electronic healthcare infrastructure to improve drug price visibility and patient outcomes. As a Certified B Corp™, Capital Rx is executing its mission through the deployment of JUDI®, the company’s cloud-native enterprise health platform, and a Single-Ledger Model™, which increases visibility and reduces variability in drug prices. JUDI connects every aspect of the pharmacy ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of pharmacy benefits and rebuilding trust in healthcare.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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