Summary

The Principal, Pricing Outcomes & Economics is a leadership role responsible for enterprise-wide ownership of pricing outcomes across the PBM organization. This position serves as the primary economic integrator between Underwriting, Network Management, Trade Relations, Finance, Clinical, and Client Strategy, ensuring financial assumptions and pricing models are aligned throughout the PBM value chain.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Own the end-to-end pricing framework, and model management across Commercial, Medicare, Medicaid, Exchange, Cash, and Mail and Specialty lines of business.
• Establish enterprise pricing governance and decision-making processes.
• Lead development and enhancement of underwriting methodologies and pricing models.
• Align client pricing strategies with network reimbursement economics.
• Partner with Trade Relations to incorporate rebate and manufacturer economics into pricing strategies.
• Monitor pricing outcomes, profitability, spread performance, rebate realization, and margin attainment.
• Develop executive KPI dashboards and variance reporting.
• Assess financial impacts of regulatory and legislative changes.
• Lead cross-functional initiatives involving Underwriting, Network, Trade, Finance, Operations, and Sales.
• Drive profitability improvement, margin preservation, and pricing optimization opportunities.

Supervisory Responsibilities

No direct supervisory responsibilities. Will need to provide project leadership and direction to pricing, underwriting, economics, and analytics team members.

Client Responsibilities

This is an internal and external client/vendor facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written).  One must be able to; manage difficult or emotional client/vendor situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

BA/BS Degree; 8+ years related experience and 8+ years of SME in respective area(s); (or equivalent combination of education and experience).

Computer Skills

To perform this job successfully, an individual should have a solid knowledge of Microsoft Office Suite. Advanced knowledge of Excel will be required including Pivot tables, V-Lookup functions, and Data importing and exporting.  Proficiency in SQL and knowledge of SAS are required.  Experience with Access and database technology a plus. 

Certificates, Licenses, Registrations

None required.

Other Skills and Abilities

• Detail oriented and very organized.
• Ability to multitask and effectively switch between various tasks throughout the day.
• Excellent prioritization skills.

Reasoning Ability

• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.

• Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Mathematical Skills

• Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume.  Ability to apply concepts of basic algebra and geometry.

Language Skills

• Excellent communication skills.

• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. 

• Ability to write routine reports and correspondence.  Ability to speak effectively before groups of customers or employees of organization.

Competencies To perform the job successfully, an individual should demonstrate the following competencies: