Director of Payor Contracting

  • Job ID:

    1732

  • Pay rate range:

    $60/hr - $70/hr

  • City:

    Louisville

  • State:

    Kentucky

  • Duration:

    03/24/2019 - 06/24/2019

  • Job Type:

    Contract to Hire

  • Job Description:

    Pay: $60-$70 per hour

    A publicly traded company is seeking a Director of Payor Contracting needed for a 3-month contract to hire opportunity for our client located in Louisville, Kentucky. 

    Job description for the Director of Payor Contracting:

    • Leads all Pharmacy 3rd party payer contract negotiations and all other contract related discussions with payers. 

    • Manages and negotiates national and regional Pharmacy 3rd Party Payer contracts to ensure company’s objectives are met in a timely manner. 

    • Assists in the maintenance and development of applicable strategies and financial reporting. 

    • Assists in development of presentation materials for internal and external meetings.  

    • Analyzes applicable Pharmacy 3rd Party Payer contracts, associated documents and proposed fees, and negotiates financial terms of contracts. 

    • Analyzes existing terms to determine if re-negotiation is warranted. 

    • Serves as the company’s primary business owner and conduit for each 3rd party payer. 

    • Coordinates negotiations with key internal and external stakeholders. 

    • Responds to internal concerns related to 3rd party Pharmacy contracts. 

    • Directs and performs analysis necessary to ascertain payer compliance with contractual obligations. 

    • Pursues disputes with 3rd party payers. 

    • Performs other tasks as assigned. 

    • Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.

    • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required.  Each essential function is required, although reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  

    Job requirements for the Director of Payor Contracting:

    • Bachelor’s degree in Business Administration or related field

    • Desired:  MBA 

    • 7+ years of health-plan contracting or provider experience

    • 7+ years of management experience in a healthcare setting 

    • 5+ years of Pharmacy 3rd party contracting experience 

    • Strong analytical, communication, management and relationship skills 

    • Advanced knowledge of Microsoft Office products (Excel, Word, Powerpoint)

    #PCFA, #Pharma, #Insurance 

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