Payer Contract Specialist - Laguna Hills - AmeriPharma

    AmeriPharma
    AmeriPharma Laguna Hills

    17 hours ago

    Description

    Payer Contract Specialist

    We are seeking a highly motivated and detail-oriented Payer Contract Specialist with a strong background in the pharmaceutical or healthcare industry. The ideal candidate will be responsible for managing all aspects of payer contracting, ensuring optimal access and reimbursement for our products. This role requires a deep understanding of managed care, commercial and government payer systems, and the ability to negotiate complex agreements.

    AmeriPharma's Benefits

    • Full benefits package including medical, dental, vision, life that fits your lifestyle and goals
    • Great pay and general compensation structures
    • Employee assistance program to assist with mental health, legal questions, financial counseling etc.
    • Comprehensive PTO and sick leave options
    • 401k program
    • Plenty of opportunities for growth and advancement
    • Company sponsored outings and team-building events
    • Casual Fridays

    Key Responsibilities

    • Contract Negotiation and Management
      • Negotiate, review, and execute payer contracts for pharmaceutical products, ensuring favorable terms and conditions for the company.
      • Manage the full contract lifecycle, from initial negotiation to renewal and termination.
      • Analyze contract performance and identify opportunities for improvement.
      • Ensure compliance with all relevant laws, regulations, and company policies.
    • Market Access and Reimbursement
      • Monitor changes in the payer landscape, including policy updates, formulary decisions, and reimbursement trends.
      • Develop and implement strategies to optimize market access and reimbursement for new and existing products.
      • Collaborate with internal stakeholders (e.g., sales, marketing, legal, finance) to support market access initiatives.
    • Data Analysis and Reporting
      • Track and analyze key performance indicators (KPIs) related to payer contracts and market access.
      • Prepare regular reports on contract status, performance, and market access trends for management.
      • Utilize data to identify areas for strategic focus and improvement in payer relations.
    • Relationship Management
      • Build and maintain strong relationships with key payer contacts and stakeholders.
      • Serve as a primary point of contact for payer-related inquiries and issues.
      • Represent the company at industry conferences and meetings as needed.
    • Cross-Functional Collaboration
      • Work closely with legal counsel to ensure contract compliance and mitigate risks.
      • Collaborate with finance to assess financial implications of contract terms.
      • Partner with sales and marketing teams to support product launch strategies and market penetration.

      Qualifications

      • Bachelor's degree in business, healthcare administration, finance, or a related field. Master's degree preferred.
      • 3+ years of experience in payer contracting within the pharmaceutical or healthcare industry.
      • Proven track record of successful contract negotiation and management.
      • In-depth knowledge of managed care organizations, commercial payers, Medicare, and Medicaid.
      • Strong understanding of pharmaceutical reimbursement methodologies and market access strategies.
      • Excellent analytical, negotiation, and communication skills (written and verbal).
      • Ability to work independently and as part of a team in a fast-paced environment.
      • Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint).

      Preferred Qualifications

      • Experience with specialty pharmacy and/or infusion therapy preferred.
      • Proven experience in managing relationships and negotiating with health plans, PBMs, and other payer organizations.

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