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Remote Provider Network Development Jobs in New Mexico

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Remote Provider Network Development information

What is a remote provider network development specialist?

A Remote Provider Network Development specialist is responsible for identifying, recruiting, and managing healthcare providers to join a health plan’s network, all while working remotely. They negotiate contracts, ensure providers meet quality standards, and maintain strong relationships to ensure network adequacy. This role often involves analyzing data to identify network gaps and collaborating with internal teams to address member needs. Remote work allows these specialists to connect with providers across various regions without needing to be on-site.

What are some common challenges faced by professionals in remote provider network development roles and how can they be addressed?

One of the main challenges in Remote Provider Network Development is building strong relationships with providers and stakeholders without regular face-to-face interaction. This requires effective virtual communication skills and the ability to leverage digital collaboration tools. Additionally, navigating differing regulations and provider expectations across regions can be complex, so staying organized and informed about local requirements is crucial. Proactively scheduling regular check-ins and utilizing centralized documentation can help maintain alignment and foster trust among network partners.

What are the key skills and qualifications needed to thrive as a remote provider network development professional, and why are they important?

To excel in Remote Provider Network Development, you need expertise in healthcare network management, contract negotiation, and provider relations, often supported by a bachelor’s degree in healthcare administration or a related field. Familiarity with health plan software, CRM tools, and knowledge of regulatory compliance systems are typically required. Strong communication, relationship-building, and problem-solving skills are essential for establishing and maintaining provider partnerships. These skills ensure effective network expansion, regulatory compliance, and high-quality service for health plan members.

What is the difference between Remote Provider Network Development vs Remote Provider Relations Specialist?

AspectRemote Provider Network DevelopmentRemote Provider Relations Specialist
Primary FocusBuilding and expanding provider networks, negotiating contractsManaging existing provider relationships, resolving issues
Required CredentialsHealthcare administration, insurance, or related certificationsCustomer service, healthcare administration certifications
Work EnvironmentStrategic planning, cross-department collaborationProvider communication, issue resolution
Industry UsageHealth insurance companies, managed care organizations

Remote Provider Network Development focuses on expanding and negotiating provider networks, while Remote Provider Relations Specialists manage ongoing provider relationships and address issues. Both roles require healthcare or insurance knowledge but differ in their strategic versus operational focus.

What are the most commonly searched types of Provider Network Development jobs in New Mexico?

The most popular types of Provider Network Development jobs in New Mexico are:

What are popular job titles related to Remote Provider Network Development jobs in New Mexico?

For Remote Provider Network Development jobs in New Mexico, the most frequently searched job titles are:

What job categories do people searching Remote Provider Network Development jobs in New Mexico look for?

The top searched job categories for Remote Provider Network Development jobs in New Mexico are:

What cities in New Mexico are hiring for Remote Provider Network Development jobs?

Cities in New Mexico with the most Remote Provider Network Development job openings:

Remote Provider Network Development jobs near you
Infographic showing various Remote Provider Network Development job openings in New Mexico as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, and 3% Contract. Highlights an 91% Physical, 3% Hybrid, and 6% Remote job distribution.

Pharmacy Network Consultant Senior - Remote

Prime Therapeutics LLC

Albuquerque, NM • On-site, Remote

$74K - $118K/yr

Full-time

Posted 8 days ago

Prime Therapeutics rating

7.9

Company rating: 7.9 out of 10

Based on 48 frontline employees who took The Breakroom Quiz

16th of 112 rated pharmacies

Job description

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.
Job Posting Title
Pharmacy Network Consultant Senior - RemoteJob Description
The Pharmacy Network Manager is responsible for development and management of Prime's retail, mail, specialty and quality-based pharmacy networks. This position is responsible for the management of Prime's network vendor's contracting activities ensuring contracting initiatives are effective and completed in accordance to Prime's Supply Chain Cost of Goods Sold (COGS) and network management strategies. This position is responsible for representing Network Management on financial audits and network management projects.
Responsibilities
  • Negotiate market competitive low to medium-high complexity pharmacy agreements for assigned pharmacies across all channels including retail, mail, specialty and quality-based channels and lines of business aligned to Supply Chain COGS strategies and compliant with Network Management policies
  • Create and manage network contracting campaigns with network vendor; analyze information and report contracting performance to Network Management leadership, Network Client Services, Network Financial Analytics, Supply Shared Services, Pharmacy FWA and Audit and other as identified; ensure all contracting initiatives meet competitive discounts and client goals for each campaign
  • Work with Prime's reporting and analytics teams to establish network reporting for Prime and vendor's pharmacy networks composition to assess network adequacy, contracting gaps and compliance with regulations
  • Represent Network Management department in audits and on cross-functional projects or Network Client Services initiatives
  • Perform network development, network analysis and management activities supporting strategy and network management priorities and projects
  • Ensure all contractual obligations are in adherence with company policies, regulatory compliance and legal requirements and engage with Legal and Network Management leadership in negotiating non-standard contract language with pharmacies
  • Establish, develop, and maintain relationships with chain, PSAOs and independent pharmacy providers
  • Manage all legal-to-legal correspondences between Prime and Pharmacy Providers escalating to Prime Legal Counsel as required
  • Other duties as assigned

Minimum Qualifications
  • Bachelor's degree in finance, business, management, or related field of study, or equivalent combination of education and/or related work experience; HS diploma or GED is required
  • 5 years of Network Management experience within Pharmacy Benefit Management (PBM), healthcare or other highly regulated industry; including 3 years of managed care experience in medical or pharmacy network contracting

Must be eligible to work in the United States without the need for work visa or residency sponsorship
Additional Qualifications
  • Excellent verbal and written presentation skills
  • Ability to work independently and on highly complex contract language and agreements; strong attention to detail
  • Ability to establish rapport and build relationships at all levels within an organization
  • Enhanced organizational skills with the ability to work on multiple projects simultaneously
  • Demonstrated ability to problem solve and interpret complex data; ability to analyze network information and synthesize it into meaningful information for a variety for audiences
  • Ability to work with confidential data and maintain privacy
  • Ability to evaluate and interpret policies and procedures

Preferred Qualifications
  • Master's degree in business, healthcare or related area of study
  • Pharmacy contracting experience within a PBM or other related healthcare industry
  • Knowledge of and experience within health care/PBM industry, Medicaid, Medicare and health plans
  • Familiarity with contract language and pharmacy reimbursement methodologies
  • Experience negotiating pharmacy solicitation contracts

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures
Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.
Potential pay for this position ranges from $74,000.00 - $118,000.00 based on experience and skills.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
Positions will be posted for a minimum of five consecutive workdays.

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About Prime Therapeutics

Sourced by ZipRecruiter

Prime Therapeutics, located in Eagan, MN, is a pharmacy benefits management company that has been serving the healthcare industry since its foundation. They are an integral participant in the medical sector, specifically in the realm of health insurance. They focus on providing innovative pharmacy benefits and services to more than 30 million members nationwide. Besides their main pharmacy benefit management, they offer mail service pharmacy, specialty pharmacy, benefits management, and consultative engagement services to ensure individuals have continuous access to affordable prescription drugs. Prime Therapeutics, founded around three decades ago, has grown to stand out as a leader in its industry, thanks to its commitment to improving the health of its clients.

Industry

Insurance services

Company size

1,001 - 5,000 Employees

Headquarters location

Eagan, MN, US

Year founded

1987

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