Contract Operations Sr. Specialist

Planet Pharma; Harmonville (PA); On-site; USD 76,000 - 90,000; Full time

Job summary

Planet Pharma in the United States is seeking a Contract Operations Sr. Specialist for US Market Access Contract Operations.

You will perform contract adjudication, analysis, and coordination to support Health Plans, PBMs, hospitals, and IDNs, ensuring compliance with terms and regulatory requirements. You will research membership eligibility, review contracting language for risk, oversee third-party contract administration, and assist with rebate processing and data validation to ensure

Qualifications

• Bachelor's degree or relevant experience in business, finance, or health administration.
• Extensive experience in pharmaceutical contracting and contract compliance.
• Experience with utilization-based contracting and administration.

Responsibilities

• Collaborate with internal and external teams to research membership and eligibility inquiries, driving toward compliant resolution.
• Conduct formal contract reviews to identify risk and feasibility of operationalizing contracting language.
• Understand and interpret contracting language to identify misalignments with system capabilities.
• Oversee contract administration tasks performed by a third-party vendor, monitoring for accuracy and completeness.
• Support contract administration and rebate processing, validating data and ensuring term compliance.
• Create and maintain compliant processes for data management and contract operations.
• Support external reporting through critical control activities and analyses.
• Contribute to the US Market Accounts Management team's projects and best practices.
• Uphold high standards of quality and accuracy in all technical work.

Skills

Managed care contracting expertise

Pricing and reimbursement in US

Market access contracting knowledge

Contract operations systems knowledge

Written and verbal communication

Attention to detail

Prioritization

Relationship building

Education

Bachelor's degree in Business, Finance, Legal Studies, Healthcare Administration, or related field

Extensive working knowledge and experience in lieu of a degree will be considered

Job description

Target Pay Rate:55-65/hr
**salary will be commensurate with experience

The Contract Operations Sr. Specialist - US Market Access Contract Operations is responsible for contract adjudication, analysis, and coordination activities in support of Managed Care customers. This position will support contracted customers including but not limited to Health Plans, Pharmacy Benefit Managers, Hospital and IDN customers and will require robust technical skills, business, and financial acumen. The highest level of compliance with contract terms and conditions, regulatory requirements, and laws is required, while also striving for strong business partnership and customer transaction excellence. The ideal candidate will support our customers and Third-Party agents in the implementation, administration, and performance reporting for specific customer agreements entered into by Market Access and Account Management that involve discounts, rebates, and other payments based on the purchase and use of products. This includes, but is not limited to, ensuring the accuracy of calculated discounts as well as compliance of contract terms and conditions, including mandated Government Pricing Programs.

Responsibilities

Primary responsibilities include and are not limited to the following:

• Collaborate with internal and external teams to research membership and eligibility inquiries, driving toward compliant resolution.
• Conduct formal contract reviews to identify risk and feasibility of operationalizing contracting language in an evolving healthcare system.
• Understand and interpret contracting language to identifying potential misalignments with current system capabilities.
• Oversee and guide contract administration tasks performed by third-party vendor, proactively monitoring for accuracy and completeness.
• Support contract administration and rebate payment processing for a diverse range of customers, including validation of data and assessment of customer compliance with contract terms.
• Create and maintain compliant processes for effective data management and contract operations.
• Support the company's external reporting through critical control activities and analyses.
• Contribute to the broader US Market Accounts Management team project portfolio, including implementation of and contributions to the team's best practices and training initiatives.
• Uphold high standards of quality and accuracy in all technical work.

Qualifications

• Bachelor's degree in Business, Finance, Legal Studies, Healthcare Administration, or related field.
• Extensive working knowledge and experience in lieu of a degree will be considered.
• 3-5 years of experience in pharmaceutical contracting, specifically Utilization-based contract compliance and administration

Experience and Skills

• Managed care contracting expertise
• Experience with pricing and reimbursement in US
• Pharmaceutical market access contracting knowledge; terms and conditions, impact of language on outcomes
• Working knowledge of pharmaceutical contract operations systems and end-to-end processes
• Clear, concise, and direct written & verbal communication
• Consistency and high attention to detail
• Ability to effectively prioritize workload
• Ability to build strong customer and internal relationships at all levels

Preferred Skills

• Broad understanding of US Health Care and product contracting environment
• Preferred: knowledge of Purchase-based contract compliance and administration

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