It's fun to work in a company where people truly BELIEVE in what they're doing!
We're committed to bringing passion and customer focus to the business.
The Director of Provider Relations is responsible for the strategic management and operational oversight of pharmacy network relationships. This role drives network performance, credentialing integrity, and provider engagement while advancing network strategy, cost efficiency, and service excellence. The Director partners cross-functionally to ensure pharmacy network alignment with organizational objectives, regulatory requirements, and client commitments.
Role and Responsibilities
- Serve as relationship owner for key pharmacy partners, including retail, specialty, and PSAO networks.
- Lead provider engagement strategies to strengthen collaboration, resolve escalations, and improve performance.
- Oversee end-to-end credentialing lifecycle for participating pharmacies, including onboarding, recredentialing, and ongoing monitoring.
- Ensure compliance with internal policies and regulatory standards, including licensure, DEA, liability coverage, and URAC standards.
- Establish and monitor key network performance metrics, including access, disruption, reimbursement, provider satisfaction, credentialing progress, and contract status.
- Analyze network trends and identify opportunities to improve cost efficiency, quality, and member experience.
- Assist in developing and executing pharmacy network strategies and operational execution aligned to growth, cost, and client objectives.
- Optimize provider relations processes, tools, and workflows to improve scalability, service levels, issue resolution, and audit readiness.
- Lead cross-functional coordination with pharmacy contracting, pricing, compliance, operations, IT, and client teams to improve provider experience and internal efficiency.
- Support client-facing engagements and ensure delivery against contractual commitments.
Qualifications and Education Requirements
- 5–6+ years of experience in PBM, pharmacy network management, or healthcare provider relations.
- Deep understanding of pharmacy credentialing, contracting, and network operations.
- Strong analytical and strategic thinking capabilities.
- Proven ability to manage provider relationships and complex negotiations.
- Executive-level communication skills with internal and external stakeholders.
Preferences
- Experience leading provider relations or network operations teams in a PBM, managed care, or pharmacy services environment.
- Demonstrated success building scalable provider operations, improving network performance, and balancing cost optimization with provider satisfaction and member access.
Physical Requirements
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. This is a largely sedentary role; however, some standing, walking, bending, and reaching may be required. Regularly operates in an office setting which involves utilizing a computer, mouse, keyboard, and occasionally operates other standard office equipment such as a printer, copier, and phone. Minimal travel may be required.
What We Do
LucyRx is an independent, next-generation pharmacy benefits manager (PBM) transforming how healthcare works. We’re fixing what’s broken in the PBM industry by putting people first and challenging outdated norms. For too long, traditional PBMs have prioritized profit over patients, and we believe that’s just plain wrong. LucyRx offers bold, innovative solutions powered by LucyIQ, our proprietary AI platform, to deliver actionable insights that lower costs, improve care, and simplify prescription management. While we’re new to the PBM space, LucyRx is built on decades of leadership experience and a commitment to meaningful change. We’re a nimble, remote-first team with a bold mission to redefine pharmacy benefits—and we’re just getting started.
What It’s Like to Work at LucyRx
At LucyRx, we’re a fast-moving team dedicated to making healthcare simpler, fairer, and more effective. Joining us means being part of a dynamic, mission-driven group that works collaboratively to challenge outdated industry practices and redefine what’s possible in pharmacy benefits. We value accountability, innovation, and a relentless focus on making an impact. Here, you’ll find a supportive culture that encourages you to bring your whole self to work, share bold ideas, and grow alongside smart, driven colleagues who are passionate about fixing the PBM industry. If you’re ready to roll up your sleeves and make a real difference, we’d love to have you on our team.
Salary:
$118,876-$139,307
Requires 5–6+ years in PBM, pharmacy network management, or healthcare provider relations; expertise in credentialing, contracting, network operations, negotiations, analytics, and strategic communication.
Key Responsibilities
- managing relationships
- overseeing credentialing
- analyzing trends
Skills & Tools
LucyIQ, computer, mouse, keyboard, printer, copier, phone
Job Details
- Category: Business Operations
- Seniority: Senior Level
- Commitment: Full Time
- Workplace: Remote — Bethesda, Maryland, United States
- Salary: USD 118,876 – 139,307 / year
- Languages: English
About LucyRx
An independent pharmacy benefits manager providing technology-powered solutions to lower costs, improve care, and simplify prescription management. — Industry: Healthcare