Pharmacy Network Contracting Director
Company: DST Systems, Inc.
Location: Kansas City
Posted on: February 22, 2021
The speed of technology. The influx of data. Shifting
regulations. Increased customer expectations.That's where you'll
find SS&C, helping clients find opportunity in ever-changing
and complex customer, business, and regulatory requirements.
Mastering complexity is a constantly changing and evolving
challenge - one that only a few people can embrace and thrive
upon.If you see your opportunity in complexity , then we are the
right fit for you.Job Description:---Organizational OverviewAs an
Associate with SS&C Health, you will be part of an organization
that promotes better health outcomes for consumers through clinical
and technological innovations. We accomplish this by leveraging the
robust technology foundation and powerful analytic resources that
are the core of SS&C, with industry leading clinical expertise
and strategic pharmacy and healthcare solutions. You will join a
team that is redefining the value of pharmacy in healthcare through
the integration of advanced analytics, clinical insights and
transformative digital capabilities.Role OverviewDevelops and
manages SS&C pharmacy networks. Develops and manages pharmacy
networks including those for retail, mail and specialty as well as
custom networks as needed within the pharmacy network claims
adjudication system. Manages the development and implementation of
statewide provider development/ communications activities.
Establishes contract negotiation priorities to support a stable and
competitive network of pharmacies nationwide. Negotiates contract
terms with assigned pharmacy chains and coordinates with internal
stakeholders to ensure offered terms are acceptable. Works with
network analytics teams on evaluating pharmacy and customer
performance. Works with network analytics team and pharmacy
operations director on establishing strategy and roadmap for
pharmacy and customer performance. The director will support
network underwriting initiatives on both potential contract
reimbursement changes, as well as bids for new
- Develops and manages pharmacy networks including those for
retail, mail and specialty as well as custom networks as needed
within the pharmacy network claims adjudication system.
- Establish and maintain relationships with pharmacy chains and
PSAOs, as well as national pharmacy organizations, i.e. NCPDP.
- Cultivates effective relationships with pharmacy provider
representatives, client representatives and internal stakeholders,
including adherence to agreed-upon rules of engagement and roles &
- Establishes contract negotiation priorities to support a stable
and competitive network of pharmacies nationwide
- Negotiates contract terms with assigned pharmacy chains and
coordinates with internal stakeholders to ensure offered terms are
- Works with network analytics teams on evaluating pharmacy and
- Works with network analytics team on establishing strategy and
roadmap for pharmacy and customer performance
- Collaborates with the Sales organization to execute company
growth initiatives through the acquisition of new networks,
providers, and vendors.
- Work with applicable teams including IT and Product for
enhancements to the pharmacy network claims adjudication
- Provide other assistance as needed to the pharmacy networks
team and other departments including the Implementation team.
- Adheres to strict procedural and regulatory compliance quality
standards, including thorough and accurate documentation, testing
protocols, and claims analysis.
- Sets high standard and encourages new ideas for improving
- Utilizes planning, prioritizing, and organizational skills to
ensure timely deliverables, high levels of quality, and efficient
use of resources
- Maintains commitment to operational goals in the face of
- Collaborates and cultivates positive relationships with
internal and external customers through delivery of sustainable,
measurable, accurate, reliable, and timely results that meet or
exceed customer expectations
- Manages processes to achieve service commitments, including
sustainable, measurable, accurate and timely execution of project
- Promptly responds to service failures, resolves issues, and
escalates concerns as appropriate
- Promotes continuous improvement by ensuring adherence to
- Seeks out and actively participates in business initiatives
that contribute to service excellence
- Work with Legal teams on creating and revising pharmacy
- Based upon career path level, completes special projects and
assignments (such as such as leading workgroups, overseeing
projects, mentoring team members, etc.)
- Support network underwriting initiatives on both potential
contract reimbursement changes, as well as bids for new
- Support the overall growth of SS&C business by functioning
as the subject-matter expert (SME) in the RFP process, the new
business implementation process and all auditing processes
- Ensure network management controls comply with contract
requirements, SSAE 16 SOC 1 control objectives, URAC accreditation
standards and any other prevailing standards for audit or
- Provide escalation and resolution of any and all Network
- Support the Director of Pharmacy Operations in all network
- Hold direct reports accountable for meeting performance
standards and departmental performance goals; mentors staff;
measures staff performance and completes regular performance
reviews and rankings.
- Create and maintain a quality assurance culture within the
department in all work processes and outcomes
- Works across the organization, with clinical and administrative
areas, to develop and deploy provider systems, standards, policies
and procedures to improve network performance.
- Bachelor's degree and 8 years of work-related experience, or
Master's degree and 6 years of work-related experience, or 10 years
equivalent work-related experience
- Ability to understand and/or have experience with NCPDP
standards and requirements.
- Proven track record of developing, maintaining and testing
claims adjudication systems or pharmacy networks.
- Experience in a Provider Relations, Chain Pharmacy, PSAO,
Client Service, or a Relationship Management role.
- Strong communication skills with the ability to develop
effective working relationships with internal and external
stakeholdersLocation:Kansas City Missouri SS&C is an equal
opportunity employer and values a diverse and inclusive workplace.
All qualified candidates will receive consideration for employment
without regard to age, race, color, religion, genetic information,
sex, sexual orientation, gender identity, national origin,
disability status, protected veteran status, or any other
characteristic protected by law. --For more information about Equal
Opportunity in the Workplace please click here-- and here .
SS&C is committed to working with and providing reasonable
accommodation to job applicants with disabilities. If you are a
qualified individual with a disability and need an accommodation or
accessibility assistance to complete the online application, please
contact us at PeopleCenter@dstsystems.com for assistance. Posted 8
Days Ago Full time R250313 About Us SS&C is a global provider
of investment and financial services and software for the financial
services and healthcare industries. Named to Fortune 1000 list as
top U.S. company based on revenue, SS&C is headquartered in
Windsor, Connecticut and has 20,000+ employees in over 90 offices
in 35 countries. Some 18,000 financial services and healthcare
organizations, from the world's largest institutions to local
firms, manage and account for their investments using SS&C's
products and services.
Keywords: DST Systems, Inc., Kansas City , Pharmacy Network Contracting Director, Executive , Kansas City, Kansas
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