Remote Payer Access & Contracting Leader

Lumicera; Springfield (IL); On-site; USD 130,000 - 190,000; Full time

Benefits offered by this job

Health, Dental, and Vision insurance

20 days PTO

4 weeks parental leave

9 paid holidays

401K company match up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan and Pro(M)

Referral Bonus Program – up to $750

Job summary

Lumicera Health Services is seeking a Payer Contracting Executive to expand payer access across commercial, Medicare Part D, and Medicaid, driving end-to-end negotiations to grow covered lives and protect margins for the specialty pharmacy network.

You will lead the development of a payer access roadmap, credentialing, pricing negotiations, and contract management, collaborating with legal, compliance and finance to ensure regulatory alignment and successful network participation.

Qualifications

• 5+ years of payer contracting, managed care or specialty pharmacy experience required.
• Experience negotiating payer or network agreements, preferably in specialty pharmacy or managed care contracting.
• Working knowledge of commercial, Medicare Part D, and Medicaid payer environments and network access requirements.
• Ability to interact cooperatively and respectfully with colleagues and stakeholders.

Responsibilities

• Lead end-to-end payer negotiations (rates, terms, networks, performance guarantees, renewals).
• Develop and execute a payer access roadmap to expand contract participation.
• Independently outreach to payers to identify credentialing and network requirements.
• Negotiate pricing and service agreements, including legal/compliance review.
• Complete credentialing and contract applications for payer/government clients.
• Track and manage contract progress with internal/external stakeholders.
• Coordinate contracts and data needs for master service agreements and scope of work documents.
• Develop relations with payers and resolve discrepancies in claims and payments.

Skills

Payer contracting

Negotiation

Education

Bachelor's degree

MBA or graduate degree

Certified Pharmacy Technician or related certification

Job description

Lumicera Health Services is seeking a Payer Contracting Executive to expand payer access across commercial, Medicare Part D, and Medicaid, driving end-to-end negotiations to grow covered lives and protect margins for the specialty pharmacy network.

You will lead the development of a payer access roadmap, credentialing, pricing negotiations, and contract management, collaborating with legal, compliance and finance to ensure regulatory alignment and successful network participation.