Job Description

Role Description

At Omnicell, we are transforming the future of pharmacy care through innovation, operational excellence, and deep partnerships across the healthcare ecosystem. As a Payor Contracts Manager, you will play a critical role in enabling access, improving reimbursement outcomes, and strengthening pharmacy network performance through strategic payer and PBM partnerships. This is an opportunity to lead impactful contract negotiations, influence network growth, and collaborate cross-functionally with legal, finance, and pharmacy operations teams.

Key Responsibilities

• Drive the successful negotiation, implementation, and optimization of PBM and payer contracts:
  • Lead negotiations of PBM and payer contracts, driving favorable business terms and sustainable pharmacy network participation.
  • Partner with internal stakeholders to execute, administer, and optimize contract performance across the lifecycle.
  • Oversee contract amendments, renewals, and terminations to ensure compliance with contractual obligations and timelines.
  • Maintain clear and accurate contract documentation and communicate key terms to stakeholders.
• Enable Pharmacy Network Participation:
  • Facilitate onboarding, participation, and offboarding of independent pharmacies within payer and PBM networks.
  • Ensure alignment between pharmacy eligibility requirements and network participation criteria.
  • Maintain accurate participation records and collaborate with pharmacy relations teams to resolve issues impacting pharmacy access.
• Operationalize PBM & Payor Contracts:
  • Interpret contract provisions and translate them into actionable operational requirements.
  • Ensure accurate implementation of reimbursement structures, participation rules, and network requirements.
  • Monitor and track contractual obligations and key deliverables across PBM and payer relationships.
• Ensure Compliance & Mitigate Risk:
  • Ensure adherence to regulatory requirements, contractual obligations, and payer policies.
  • Support internal and external audits related to PBM/payer contracts and pharmacy network participation.
  • Identify compliance risks and proactively escalate and resolve issues.
• Optimize Reimbursement Performance:
  • Lead resolution of complex reimbursement and claims issues, including reprocessing and negotiated adjustments.
  • Partner with finance and operational teams to ensure payment accuracy and reconciliation.
  • Develop strategies to maximize reimbursement outcomes for participating pharmacies.
• Drive Cross-Functional Collaboration:
  • Serve as a key liaison between contracting, pharmacy relations, legal, and finance teams.
  • Provide operational insights to support contract negotiations and network strategies.
  • Build strong partnerships to align contract execution with business objectives.
• Leverage Data & Insights:
  • Analyze trends related to reimbursement, claim rejections, and network performance.
  • Develop and deliver reporting on:
    • Pharmacy network participation.
    • Contract lifecycle and renewals.
    • PBM participation and performance metrics.
    • Compliance tracking and audit readiness.
  • Provide actionable insights and recommendations to senior leadership.
• Champion Process Improvement:
  • Identify and implement scalable processes to support expanding pharmacy networks.
  • Enhance contract tracking systems and participation monitoring tools.
  • Drive continuous improvement initiatives to increase efficiency and accuracy in contract administration.

Qualifications

• 5+ years of experience in healthcare contracting, PBM contract administration, pharmacy network operations, or PSAO environments.
• Strong knowledge of PBM contracts, payer networks, reimbursement methodologies, and regulatory requirements.
• Negotiation skills with the ability to influence internal and external stakeholders.
• Strong analytical, problem-solving, and organizational skills with high attention to detail.
• Proficiency in Microsoft Office tools (especially Excel) and familiarity with pharmacy or credentialing systems.

Requirements

• PSAO knowledge and experience.
• Experience with specialty pharmacy operations or 340B program participation.
• Experience interpreting and operationalizing complex contract language.
• Paralegal experience or legal contract training.
• Bachelor’s degree in Business, Healthcare Administration, Pharmacy Administration, or a related field.
• Relevant certifications such as RPh or Certified Pharmacy Technician (CPhT).
• Proven ability to manage multiple priorities and deliver results in a fast-paced environment.

Benefits

• The expected salary range for this role is $100,000 to $175,000 per year, depending on experience, qualifications, and geographic location.
• This position is eligible for a 9% annual bonus opportunity.
• Omnicell's comprehensive benefits package.

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