Insight Enterprises Inc

PBM Partnerships & Payer Relations Manager

Insight Enterprises Inc • $95K — $115K *
Flint, MI 48504In-Person
Healthcare
Less than 5 years of experience
Reposted Today
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Job Overview by Ladders

Qualifications

  • Bachelor's degree in Business, Healthcare Administration, Pharmacy, or a related field
  • Experience with PBMs, payers, networks, benefits administrators, or pharmacy operations
  • Strong communication, negotiation, and relationship-management skills
  • Ability to manage contracts, escalations, timelines, and multi-stakeholder relationships
  • Strong analytical thinking and problem-solving skills.

Responsibilities

  • Serve as the main liaison for all PBM partners and associated vendors
  • Manage onboarding, implementations, and ongoing communications
  • Oversee contract execution and escalation resolution
  • Build new relationships with self-funded employers and brokers
  • Drive expansion into new PBM networks and payer groups
  • Troubleshoot operational issues and reimbursement discrepancies
  • Track reimbursement patterns and PBM performance metrics.

Benefits

  • Opportunities for professional development
  • Collaborative work environment
  • Potential for industry networking opportunities
  • Engagement in strategic discussions and events.
Full Job Description
Position Overview
We are seeking a proactive, relationship-driven PBM Partnerships & Payer Relations Manager to serve as the primary point of contact for Pharmacy Benefit Managers (PBMs), third-party administrators (TPAs), brokers, and self-funded employer groups. This role is responsible for building new partnerships, strengthening existing relationships, supporting contract execution, ensuring operational accuracy, and driving network growth across all payer and PBM channels. The ideal candidate excels at communication, problem-solving, and business development within the pharmacy or healthcare benefits ecosystem.

Benefits:
  • Comprehensive health, dental, and vision insurance
  • Paid time off: vacation, holidays, and sick leave
  • 401(k) with employer match (immediate vesting; eligibility begins after 3 months)
  • Employer - paid short - and long - term disability, basic life insurance
  • Voluntary coverages: accident, critical illness, hospital indemnity, AD&D, etc.


Key Responsibilities:

PBM Partnership Management
  • Serve as the main liaison for all PBM partners, contractors, TPAs, and associated vendors.
  • Manage onboarding, implementations, and ongoing communication to ensure alignment and strong operational performance.
  • Oversee contract execution, version control, and escalation resolution with external partners.
  • Proactively step in to assist with prior authorizations or operational duties as needed to ensure exceptional service continuity.
  • Maintain a clear understanding of PBM reimbursement strategies, plan designs, MAC pricing, and specialty pharmacy dynamics.
  • Step in to assist with PAs or operations during high-volume periods or staffing gaps.


Self-Funded Employer Network Development
  • Build new relationships with self-funded employers, brokers, benefits consultants, and employer coalitions.
  • Identify opportunities for employers to utilize the pharmacy as a preferred or direct-to-employer solution (specialty savings, infusion savings, carve-outs).
  • Present pharmacy value propositions, cost-savings models, and service offerings to employer groups.
  • Support the execution of direct-to-employer agreements and develop customized employer workflows.

Payer & Network Growth
  • Drive expansion into new PBM networks, payer groups, and employer health plans.
  • Research and pursue opportunities to improve reimbursement rates or negotiate favorable contract terms.
  • Track market trends, competitive pricing, and plan changes influencing pharmacy performance.
  • Strengthen ties with existing PBM and payer partners to secure long-term relationships.


Operational & Contract Coordination
  • Troubleshoot operational issues, adjudication errors, reimbursement discrepancies, and network constraints.
  • Collaborate with internal teams (legal, finance, operations, pharmacy) to ensure contractual accuracy and workflow alignment.
  • Maintain oversight of contract renewals, amendments, compliance obligations, and key dates.
  • Support renegotiation efforts by preparing comparisons, contract reviews, and partner summaries.


Performance Monitoring & Reporting
  • Track reimbursement patterns, adjudication behaviors, specialty margins, and PBM performance metrics.
  • Generate internal reporting to evaluate partnership effectiveness and financial outcomes.
  • Identify opportunities to optimize pricing strategies, improve patient access, and enhance profitability.


Relationship Building & Strategic Development
  • Cultivate strong, trust-based relationships with PBM executives, employer decision-makers, consultants, and industry partners.
  • Represent the organization at meetings, conferences, and strategic discussions.
  • Identify emerging opportunities for collaboration, market expansion, or product/service enhancement.


Required Qualifications
  • Bachelor's degree in Business, Healthcare Administration, Pharmacy, or a related field.
  • Experience working with PBMs, payers, networks, benefits administrators, or pharmacy operations.
  • Strong communication, negotiation, and relationship-management skills.
  • Ability to manage contracts, escalations, timelines, and multi-stakeholder relationships.
  • Strong analytical thinking, problem-solving skills, and organizational abilities.


Preferred Qualifications
  • Prior experience working directly with PBMs, TPAs, or self-funded employer groups.
  • Experience in specialty pharmacy, infusion services, or pharmacy network contracting.
  • Working knowledge of claim adjudication, reimbursement structures, MAC lists, spread pricing, and DIR fee models.
  • Experience building direct-to-employer pharmacy programs or benefit carve-out models.
  • Familiarity with value-based pharmacy programs, outcomes reporting, and data-driven performance metrics.
  • Strong understanding of healthcare contracting, payer policies, and benefits administration.
  • Ability to interpret contract terms, fee schedules, and reimbursement methodologies.
  • Experience presenting pharmacy solutions or savings programs to employers, payers, or consultants.
  • Existing relationships with PBMs, benefit brokers, employer groups, or industry partners is a major plus.

About Insight Enterprises Inc

Insight Enterprises Inc Careers

Join the dynamic team at Insight Enterprises Inc, a leading provider in IT solutions and services globally. As a hub of innovation and leadership, Insight Enterprises Inc offers unparalleled job opportunities for professionals eager to drive technological advancements and transformative solutions. Work You’ll Do At Insight Enterprises Inc, you will be part of a culture that thrives on diversity, professional growth, and collaborative success. Our team is dedicated to fostering an environment where creativity and innovation meet to deliver outstanding results for some of the most well-known companies worldwide. Lead in a Unique Market Position Insight Enterprises Inc stands at the forefront of the IT industry, blending cutting-edge technology solutions with deep industry expertise. This unique position allows our team to lead and excel in digital innovation, making us a prime destination for those looking to impact the tech landscape significantly. Engage with a Global Team Collaborate with a global network of professionals who are leaders in technology and business strategy. Our diverse team of over 11,000 members worldwide offers a rich environment for networking, sharing ideas, and pushing the boundaries of what's possible. Insight Enterprises Inc Career Opportunities We are continuously expanding our team and looking for talented individuals who bring a passion for technology and a drive for excellence. Whether you’re seeking a position in management, engineering, sales, or customer support, Insight Enterprises Inc provides a platform to enhance your career. Innovative Work Join us and contribute to projects that redefine industry standards and lead to real-world solutions. At Insight Enterprises Inc, innovation is at the core of what we do. We encourage our team to bring fresh ideas that pave the way for technological advancements and improved client solutions. Be Part of a Great Team At Insight Enterprises Inc, we believe in the power of our people. We are committed to providing our employees with the benefits and support they need to thrive both professionally and personally. From comprehensive health benefits to professional development and leadership training, we invest in our employees' futures. Internship and Employment Opportunities Start your career with Insight Enterprises Inc through our internship programs or full-time employment opportunities. We offer positions that challenge your skills and allow you to grow with the company. Our hiring process is designed to identify and foster leadership potential and to equip you with the necessary tools for a successful career. Stay Connected Join Our Team Explore the various job opportunities at Insight Enterprises Inc by searching open positions that match your skills and interests. We are looking for innovative, curious, and driven team players who are ready to make a significant impact. Keep Up to Date Stay informed with the latest career tips, industry insights, and company news—all from the team at Insight Enterprises Inc. Our careers blog is your go-to resource for everything from resume tips to interview preparation. Job Alert Emails Customize your subscription to receive job alerts and insider information tailored to your preferences. Discover the exciting and rewarding career opportunities waiting for you at Insight Enterprises Inc. Join Insight Enterprises Inc today and be part of a team that values innovation, leadership, and diversity. Shape your future in an environment where your work makes a real difference.
Learn more about Insight Enterprises Inc
Size
11,624 employees
Market Cap
$3.4 billion
Industry
Business Services
Net Income
$172.6 million
Founded
1988
5 Year Trend
+11.5%
Revenue
$8.3 billion
NASDAQ
NSIT
* Ladders Estimates

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