Remote Payer Contracting Executive | Access & Growth

Lumicera; Baton Rouge (LA); On-site; USD 120,000 - 180,000; Full time

Benefits offered by this job

Health, Dental, and Vision insurance

Paid time off (20 days)

Parental leave (4 weeks)

9 paid holidays

401K company match (up to 5%)

Adoption assistance

Flexible Spending Account

Educational assistance and membership

Referral bonus program

Job summary

Lumicera Health Services is seeking a Payer Contracting Executive to expand payer access across commercial, Medicare Part D, and Medicaid opportunities. You will lead end-to-end negotiations, credentialing, and contract administration to grow covered lives and protect margins for specialty pharmacy.

You will collaborate with cross-functional teams including legal, compliance, and finance to ensure contracts meet regulatory requirements and business goals.

Qualifications

• Bachelor's degree required; MBA or other graduate degree preferred.
• Certified Pharmacy Technician or relevant industry certification preferred.
• 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, required.
• Working knowledge of commercial, Medicare Part D, and Medicaid payer environments and network access requirements required.
• Participate in, adhere to, and support compliance program objectives.

Responsibilities

• Lead payer negotiations end to end, including rate and term negotiation, network participation, performance guarantee structures, and renewal strategy.
• Develop and execute a payer access roadmap for expanded payer contracts.
• Independently outreach to payers to identify credentialing and network requirements and pursue new access opportunities.
• Establish, monitor, and negotiate pricing and service agreements with payers, including legal and compliance review.
• Complete credentialing and new contract applications for payer and government clients, and compile supporting documents.

Skills

Payer contracting

Contract negotiation

Managed care

Specialty pharmacy

Regulatory compliance

Communication skills

Education

Bachelor's degree

MBA or graduate degree (preferred)

Job description

Lumicera Health Services is seeking a Payer Contracting Executive to expand payer access across commercial, Medicare Part D, and Medicaid opportunities. You will lead end-to-end negotiations, credentialing, and contract administration to grow covered lives and protect margins for specialty pharmacy.

You will collaborate with cross-functional teams including legal, compliance, and finance to ensure contracts meet regulatory requirements and business goals.