Position Overview:

The Payer Relations Contracting Specialist is responsible for managing and optimizing contracts with third-party payers (insurance companies, PBMs, CMS) for pharmacy services.

Strong understanding of payer contracts, healthcare reimbursement processes, and relevant regulations
Excellent analytical, communications, and interpersonal skills
Proficiency in Microsoft Office Suite, particularly in Excel and Word

Ensure timely execution of contracts.
Maintain accurate records of all contract activities.
Manage contract lifecycles, renewals and amendments.
Maintain accurate and up-to-date contract records.
Conduct regular audits of contract compliance with applicable laws, regulations, and company policies.
Collaborate with internal teams, including pharmacy operations, finance, and legal, to ensure effective contract management.
Provide guidance on contract-related issues to internal stakeholders.
Identify and mitigate potential risks associated with payer contracts.
Resolve contract disputes and issues.
Maintain contract continuity through performing required credentialing with payers.
Support the legal team in contract-related matters.
Develop and maintain contract templates and documentation.
Develop and implement contract management policies and procedures.
Participate in cross-functional projects and initiatives.
Stay up to date on industry trends and regulatory changes related to payer contracts.

Fast-paced environment.
Requires normal vision (corrected) both close and distant.
Requires normal hearing levels (corrected).
Requires working at a desk to use a phone and computer for extended periods of time. Requires sitting, bending.
Works effectively with frequent interruptions.