Principal, Pricing Outcomes and Economics

About the role

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

• 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.

Qualifications

• BA/BS Degree; 8+ years related experience and 8+ years of SME in respective area(s); or equivalent combination of education and experience.
• Solid knowledge of Microsoft Office Suite; advanced knowledge of Excel 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.
• Detail oriented and very organized.
• Ability to multitask and effectively switch between various tasks throughout the day.
• Excellent prioritization skills.
• 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.
• 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.
• 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.

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.

Work Location & Schedule

Full time remote location is acceptable. This position will require some on-site work at the San Diego Headquarters or other company location on occasion. Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders. This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm. This position may require domestic travel of up to 25% of time.

Benefits

• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• Incentive Compensation
• 401K with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus