The Pharmacy Network Executive will be the core custodian of our pharmaceutical benefits scheme.
You will manage partnerships with retail pharmacies, hospital pharmacies, and drug manufacturing stakeholders. Your primary focus will be controlling drug spend, eliminating fraud, ensuring clinical compliance with national formularies, and guaranteeing that our enrollees receive safe, genuine medications seamlessly.
This is a full-time, in-person, on-site role requiring physical presence at the Head Office and standard operational fieldwork.
Key Responsibilities
Network Management & Credentialing: Recruit, onboard, and manage relationships with a nationwide network of community pharmacies and diagnostic hubs.
Claims Review & Cost Optimization: Audit and vet pharmaceutical claims submitted by providers to detect errors, over-invoicing, and fraudulent billing practices.
Formulary & Tariff Management: Maintain, review, and regularly update the company's drug formulary and price tariffs to ensure cost-efficiency and clinical relevance.
Quality Assurance & Compliance: Ensure all network pharmacies strictly comply with regulations set by the Pharmacy Council of Nigeria (PCN), NAFDAC, and standard health insurance protocols.
Pre-Authorization & Clinical Support: Provide expert clinical oversight for high-cost, specialized, or chronic disease medication requests escalated by the Call Centre Agents and Case Management Team.
Dispute Resolution & Field Audits: Conduct periodic routine and spot-check clinical audits of paneled pharmacies to verify drug storage conditions (including cold chain management) and inventory logs.
Save Costs: Work on special plans to keep medicine affordable for our enrollees while maintaining high quality.
Required Qualifications & Experience
Education: Bachelor of Pharmacy (B.Pharm) degree from an accredited institution.
Licensing: Current, valid practicing license from the Pharmacy Council of Nigeria (PCN)
Experience: 2 - 3 years of post-NYSC experience. Prior experience working within a Health Insurance Company (HMO), Managed Care Organization, or a major digital pharmacy network aggregator is highly preferred.
Skills:
Deep understanding of managed care pharmacy, drug tariffs, and health insurance dynamics.
Advanced data analysis skills with proficiency in Microsoft Excel or healthcare Customer Relationship Management (CRM) platforms.
Strong negotiation, stakeholder management, and interpersonal communication skills.
Availability:
Willingness to work fully in-person at our office and embark on physical pharmacy facility inspections when necessary.
What We Offer
Competitive Gross Salary and Performance-Based Incentive.
Health Insurance Coverage.
Group Life Insurance
Paid annual leave and Continuous Professional Development (CPD) support.
A vibrant, collaborative, physical workspace environment at Masslife Healthcare Limited.