We’re in this for the greater good at ParetoHealth. Our mission is collective greatness, nothing less will do. Our team is a single force united in the drive to transform employee health benefits.
The company was founded in 2011 to help small and medium-sized businesses fight the rising cost of employee health benefits. We blazed the trail with financing innovations that reduce the risks in self-insurance and deliver significant savings—and we continue to lead with a growing ecosystem of partners and world-class cost control solutions.But success is measured by more than dollars alone and we measure ours by the good that comes from knowing that every client and all their employees can count on effective, affordable healthcare for years to come.
Please note that ParetoHealth does not provide employment visa sponsorship for this position. Candidates must be authorized to work in the United States without sponsorship both now or in the future.
Position Summary:
As Head of Pharmacy Strategy & Partnerships, you will be the primary driver of Pareto’s pharmacy benefit manager (PBM) consortium partnerships. You’ll spend your time owning all facets of our PBM Pareto Rx Consortium (“PRxC”) which includes: leading the partnership strategy for who is added to the Consortium as well as all— contracting, invoice reconciliation, performance guarantees, operational workflows (pricing assessments, implementation, renewals), data integrations, and customer experience enhancements.
This will also include leading business development and partnership activity to identify additional areas of Pharmacy cost containment across areas such as specialty pharmacy, international sourcing, 340B and GLP-1 spend management.The Head of Pharmacy Strategy & Partnerships will serve as both the internal and external subject matter expert on these partnerships, which includes leading presentations at client and prospect events.
Key Responsibilities:
Pharmacy Strategy & Partnerships Leadership
- Expansion and BD Strategy: Identifying, vetting and negotiating with potential new PBM participants in PRxC
- Contracting & Relationship Management: Lead rate negotiations, performance guarantees, carve‑outs, and reimbursement methodologies across all PRxC and other Rx cost containment partnerships.
- Invoice Reconciliation & Guarantee Monitoring: Own processes for invoice review, dispute resolution, and performance tracking to ensure contractual compliance and client satisfaction.
- Operational Workflow Definition: Design and roll out standardized workflows for pricing assessments, invoice issuance, client implementations, and annual renewals.
- Data & Analytics Integration: Enhance data‑sharing pipelines and analytics dashboards with PBM partners to drive transparency and actionable insights.
- Point‑Solution Identification: Research, pilot, and implement overlay solutions (e.g., specialty pharmacy carve‑outs, rebate maximizers) to further reduce pharmacy spend.
- Customer Experience Optimization: Streamline end‑to‑end experience from pricing request to ongoing account management in partnership with Client Services and Product teams.
Required Skills & Qualifications:
- Experience: 10+ years in PBM and/or TPA partnership management, preferably within self‑insurance, consultancy, or managed care environments.
- Technical Expertise: Deep understanding of PBM contracting (rebates, guarantees, carve‑outs) and TPA plan administration, including stop loss carrier and consultant landscapes.
- Operational Excellence: Proven ability to define, document, and scale complex workflows and processes; strong detail‑orientation.
- Relationship Management: Executive‑level presence with a demonstrated track record of cultivating and growing partnerships; relationship‑driven and initiative‑oriented.
- Analytical Skills: Comfort working with data to drive decisions—experience with invoice reconciliation, KPI scorecards, and performance monitoring.
- Communication: Outstanding written and verbal communication; adept at influencing senior stakeholders.
- Pace & Ownership: Thrives in fast‑paced environments, managing multiple priorities with urgency and ownership.
- Travel: Willingness to travel up to 25%, including to Pareto HQ in Philadelphia and client sites.
- Education: Bachelor’s degree in Business, Finance, Pharmacy, Health Administration, or related field.
- MBA, PharmD, or advanced degree preferred
- Experience building or scaling consortium/multi‑vendor network models preferred
- Familiarity with specialty pharmacy and emerging point‑solution vendors preferred
- Proficiency with analytics tools (SQL, Tableau, Python) preferred
We are guided by our values:
Fire in the belly
The drive to learn, to improve, and to deliver outstanding value every day.
See the field
The ability to see the big picture and prepare to meet tomorrow’s needs.
Get it done right
The passion to produce at higher rates and to the highest standards.
For the greater good
A united community creating better health benefit solutions for all.
Please note that any communication from our recruiters and hiring managers at ParetoHealth about a job opportunity will only be made by a ParetoHealth employee with an @paretohealth.com address. ParetoHealth does not conduct text message or chat-based interviews. Any other email addresses, agencies, or forums may be phishing scams designed to obtain your personal information.
We will not ask you to provide personal or financial information, including, but not limited to, your social security number, online account passwords, credit card numbers, passport information, and other related banking information until we begin onboarding activities, which will be coordinated by a member of the ParetoHealth People Ops Team with an @paretohealth.com email address.
Disclosures:
ParetoHealth is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations. These activities include, but are not limited to, hiring and firing of staff, selection of volunteers and vendors, and provision of services. We are committed to providing an inclusive and welcoming environment for all members of our staff, clients, volunteers, subcontractors, vendors, and clients.
California Applicants: SeePareto’s CCPA Notice of Collection for California Employees and Applicantsfor information about how Pareto Captive Services, LLC, Pareto Health, LLC, and Pareto Underwriting Partners, LLC, together with their respective subsidiaries (collectively, “Pareto”) collects and uses personal information submitted by employment applicants.
