System Manager, Community Operations & Payer Contracting - Hybrid

System Manager, Community Operations & Payer Contracting

The System Manager, Community Operations & Payer Contracting is a remote leadership position reporting to the System Director, Community Pharmacy. This role is central to advancing Baptist Health's community and retail pharmacy services by overseeing both operational excellence and strategic payer contracting initiatives. This position is responsible for the planning, development, and day-to-day operations of all Baptist Health community and retail pharmacies. It includes executing the launch and implementation of new pharmacy locations, collaborating with the Ambulatory Pharmacy Compliance Manager and the System Director, Community Pharmacy to ensure pharmacy operations align with established policies, supporting strategic initiatives across procurement, clinical services, quality assurance, and leadership development, monitoring key performance indicators for outpatient pharmacy services and developing improvement plans, managing the community/retail pharmacy floater pool and conducting onsite visits to pharmacy locations and patient engagement areas at the Central Pharmacy Services Center. The System Manager, Community Operations & Payer Contracting plays a critical part in expanding Baptist Health's payer relationships and pharmacy network access. Responsibilities include leading business development strategies to engage pharmacy payers and capitalize on Baptist Health's geographic reach, partnering with ambulatory and specialty pharmacy leadership to broaden internal dispensing capabilities, providing administrative oversight for pharmacy payer contracting by executing contracting goals and strategies, managing PBM retail contracts and credentialing applications, reviewing provider manual changes to ensure compliance, overseeing timely payment and reconciliation for PBM reimbursements, and supporting specialty pharmacy payer agreements. The System Manager, Community Operations & Payer Contracting will work cross-functionally to establish and update operational policies and procedures.

Baptist Health is looking for a System Manager, Community Operations & Payer Contracting to join our Pharmacy team at our Central Pharmacy in LaGrange, KY! This is a hybrid role, working in the office at times and at home.

• Assist System Director, Community Pharmacy in planning, development, and execution of operations across all Baptist Health community/retail pharmacies.
• Collaborate with the Ambulatory Pharmacy Compliance Manager and System Director, Community Pharmacy to ensure compliance with operational policies and procedures.
• Support the launch and implementation of new community pharmacy locations.
• Assist System Director, Community Pharmacy in driving strategic initiatives in areas such as procurement, clinical services, quality assurance, and leadership development.
• Monitor outpatient pharmacy performance indicators and support improvement plans.
• Manage the community/retail pharmacy floater pool and conduct onsite visits to pharmacies and patient engagement areas at the Central Pharmacy Services Center.
• Experienced leader in community/retail pharmacy management.
• Develop and execute business strategies to expand Baptist Health's engagement with pharmacy payers, leveraging the system's geographic footprint.
• Identify opportunities for population health management and revenue growth through payer partnerships.
• Lead contracting efforts with pharmacy benefit managers (PBMs), including oversight of provider manual updates, ensuring compliance with contract terms, timely payment and reconciliation.
• Supports community/retail pharmacy staff selection and professional growth and development.
• Works cooperatively with internal medical group personnel to promote and maintain good interpersonal and interdepartmental communication.
• Provides direction, expertise, and leadership for community/retail pharmacy teams to optimize services and efficiencies in collaboration with central pharmacy and specialty teams.
• In the absence of the System Director, Community Pharmacy, directs the organization's ongoing pharmacy functions in coordination with the Chief Pharmacy Officer, including employee training and development, managing pharmacy budgets and approval of marketing activities.

Minimum Requirements

• Bachelor's degree in pharmacy or Doctorate of Pharmacy required.

• 1-3 years related work experience.

• Kentucky Board of Pharmacy license in good standing.

• Indiana Board of Pharmacy license or willing and eligible to achieve within 12 months of hire.

• Knowledge of state and federal pharmacy laws and regulations. Strong understanding of clinical quality standards and regulatory compliance.

• Proven track record in onboarding new pharmacy payers and operationalizing contract requirements.

• Must obtain 340B University Training within 6 months.

• Experience with payer contracting preferred.

If you would like to be part of a growing family focused on supporting clinical excellence, teamwork and innovation, we urge you to apply now!

Baptist Health is an Equal Employment Opportunity employer.