Payer Relations Contracting Specialist

Senderra Rx Partners, Llc; Dallas (TX); On-site; USD 60,000 - 80,000; Full time

Job summary

A healthcare services company in Dallas is seeking a Payer Relations Contracting Specialist to manage and optimize contracts with third-party payers. The role requires a Bachelor's degree in a relevant field and 2+ years of experience in contract management. Key responsibilities include ensuring timely execution of contracts and collaborating with internal teams. Candidates should possess strong analytical and communication skills along with proficiency in Microsoft Office Suite.

Qualifications

• 2+ years of experience in contract management.
• Strong understanding of payer contracts and healthcare reimbursement processes.
• Ability to resolve contract disputes effectively.

Responsibilities

• Ensure timely execution of contracts.
• Maintain accurate records of all contract activities.
• Manage contract lifecycles, renewals, and amendments.

Skills

Analytical skills

Communication skills

Interpersonal skills

Proficiency in Microsoft Office Suite

Education

Bachelor’s degree in Business Administration, Healthcare Management, or related field

Tools

Microsoft Excel

Microsoft Word

Job description

Overview

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

Education / Licensing Requirements

• Bachelor’s degree in Business Administration, Healthcare Management, or related field desired

Experience Requirements

• 2+ years of experience in contract management
• 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

Characteristics

• Sense of urgency
• Organized, detail-oriented, catches errors early
• Ethical; respects confidentiality

Responsibilities

• Ensure timely execution of contracts.
• Maintain accurate records of all contract activities.
• Manage contract lifecycles, renewals and amendments.
• 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.

Working Conditions

• 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.