Director, Pharmacy Network Pricing & Market Planning

Due to growth, we are adding a Director, Network Pricing & Market Planning to our team!

The Director, Network Pricing & Market Planning is responsible for owning pharmacy network financial performance across all lines of business, with direct accountability for achieving contracted reimbursement guarantees, including effective rate (BER/GER) performance and MAC pricing outcomes.

This role leads the Network Reconciliation and MAC Pricing teams and is accountable for ensuring that contracted pharmacy rates are operationalized, monitored, and achieved.

The Director focuses on performance execution—translating network pricing strategies into realized financial outcomes through rigorous reconciliation, variance management, and pricing intervention.

The Director partners with Network Contracting, Underwriting, Finance, and Analytics leadership to ensure alignment between contracted terms and financial outcomes.

Unlike strategy or informatics roles, this position is accountable for post-contract performance realization—owning the processes, teams, and controls that ensure pharmacy reimbursement aligns with contractual expectations.

This includes reconciliation oversight, effective rate compliance, MAC performance, and corrective action when performance deviates.

Is this you?

Find out more below!

How do I make an impact on my team?

• Lead the Network Reconciliation function with full accountability for validating pharmacy network performance against contracted effective rates (BER/GER) and pricing guarantees.
• Own reconciliation outcomes across all lines of business, ensuring accurate financial settlement and alignment to contract terms.
• Establish and enforce processes to monitor, measure, and report on network performance vs. contractual targets (e.g., AWP discounts, effective rate thresholds). Identify performance variances and drive corrective actions in partnership with Network Contracting and Pricing teams.
• Insure audit readiness, financial transparency, and governance across all reconciliation activities.
• Provide oversight of pharmacy network performance across all pricing constructs (e.g., effective rate, MAC, NADAC, PAC, flat AWP), ensuring reported outcomes align with contracted reimbursement intent, even where pricing methodologies are managed outside of this function.