Why you’ll love it here We are abarca health, a fast-growing PBM and Health Information Technology Company that provides solutions to help our clients lower their costs, improve their services, and streamline their operations. At the core of our industry advantage is our proprietary PBM platform, which is a first-rate SaaS offering. We state this while keeping in mind that any and all of our success is due to our people’s drive and commitment to being “all in”, a quality that is part of the Abarcan DNA and an essential element for us to continue being a distinctive organization that adds significant value to our awesome clients and all of us who work here.

Do you have the Abarcan DNA? Here, you’ll forget half-measures, wholly commit to your passion for delivering the best service, get a chance to do things differently, and all while being part of an industry leader. We’ll be open from the get-go: if “hands-on” and “devoted” are not your work style, then we are better off as ships passing in the night.

What you’ll do

In a few words…

In the role of Sr. Director, Pharmacy Networks & Underwriting you will be leading and managing the strategy of the pharmacy network, working closely with the Pharmacy Partnership, Finance, as well as the Analytics team. You will also be a strong contributor to the Underwriting Committee. Your responsibilities include maintaining and building our pharmacy network footprint that both serves our clients today and helps us be competitive as we pursue new growth opportunities, all while honoring our Better Way approach. You must acquire and maintain expert knowledge of internal underwriting, analytic and pricing models to analyze, review and approve client financial offerings that maintain the highest levels of accuracy in forecasting Abarca’s profitability and client savings. You are expected to be proactive, strategic and identify areas of potential risk and implement process improvements to mitigate risk, use data to create compelling value statements on pricing and savings opportunities to assist in closing new business and retaining current client opportunities. While setting the strategy is important, we aren’t a love it and leave it kind of organization… you’ll be responsible for ongoing monitoring and managing of the networks’ financial and quality performance and making adjustments as necessary to ensure we are meeting our overall and client specific network objectives. Other equally important aspects of the job include participation in business development activities, which may include: underwriting, RFP responses, system demonstrations, presentations and conferences. Inspired to aspire?

The fundamentals for the job…

  • Develop, execute and maintain pharmacy network strategies for US mainland and in Puerto Rico; including participants, network size, reimbursement drivers and terms (discounts, DIR, incentives), quality criteria and other contracting elements;
  • Establish and maintain executive-level relationships with pharmacy chains and PSAOs, as well as national pharmacy organizations, i.e. NCPDP, NCPA, Puerto Rico based groups (Association of Community Pharmacies, Aliadas, Coopharma);
  • Negotiate pharmacy contracts;
  • Utilizing state-of-the-art dashboards and other analytical tools, monitor network performance to ensure contract compliance and alignment with network objectives. Oversee remediation for any non-complying areas;
  • Align with Pharmacy Partnerships team on network education and other outreach initiatives;
  • Lead network underwriting initiatives on both potential contract reimbursement changes, as well as bids for new business;
  • Present pricing proposal recommendations, data analysis, and financial models to Abarca leadership, as well as external parties.
  • Participate and support business development activities as requested.

  • What you’re made of

The bold requirements…

  • Bachelor’s Degree in Pharmacy, Business, Math, Computer Systems, or a related field, with 5+ years of professional experience, preferably within a PBM or health plan (In lieu of a degree, equivalent relevant work experience may be considered.)
  • Previous underwriting or financial analysis and marketing experience with PBM or health plan would be helpful to your cause.
  • This position requires strong computer proficiency, knowledge of Microsoft Office (Word, Excel, PowerPoint) products, and experience with Internet research (basic digital skills you will use on a daily basis).
  • Knowledge of PBM financial operations, Medicare Part D, and Insurance is a great, big, fat, happy plus.
  • This position will require your head being on a swivel allowing you to maintain expert knowledge of the PBM industry, current/emerging pharmacy trend management strategies, and current/emerging Abarca product offerings.
  • Excellent interpersonal skills and ability to work well with all levels of internal management and staff, as well as outside clients and vendors.
  • Attention to detail and a customer service focus.
  • You can communicate effectively (read, write, speak, daydream, argue, flatter, chatter, etc.) in English.

That something extra we´d love to see…

  • Detailed: Nothing gets by you and you rarely forget a thing. When learning some new procedure, you’re the type to take notes. When everyone else is still lost, you’re already at the next steps. Due to your detailed nature, you are also exquisitely good at planning, and follow through, meticulously.
  • Negotiator: You navigate difficult conversations towards productive outcomes. You are driven to achieve the elusive win-win. You have a certain aplomb that can take control of a situation and make decisions. You must not get over your skis and exercise sound business judgment to achieve proper balance between client wins (vanity) and our profitability (sanity).
  • Persuasive: You have a way about you… a way that gets your way, but in a good way. Often impatient, you turn thought into action and make things happen by swaying others… a fantastic snake charmer.
  • Focused: You take direction, follow through, and make the necessary corrections to stay on track. Prioritize, and then act. You are like a super soldier or an average termite: your focus is a super power.
  • Organized: You are strong in the Organization area, and you enjoy order. Disorder is like constant noise to you, and you can’t stand it.

It is the policy of Abarca Health, LLC, its affiliates and subsidiaries (“Abarca”), to provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, genetics, or any other characteristic protected by federal, state or local law. In addition,. In addition to federal law requirements, Abarca complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Abarca expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Abarca’s employees to perform their job duties may result in discipline up to and including discharge.