Remote Payer Contracting Executive — Access & Margin Growth

Lumicera; Carson City (NV); Remote; USD 120,000 - 170,000; Full time

Benefits offered by this job

Health benefits

PTO

Parental leave

401K match

Adoption assistance

FSAs

Education assistance

Referral bonus

Job summary

Lumicera Health Services is seeking a Payer Contracting Executive to drive end-to-end payer negotiations across commercial, Medicare Part D, and Medicaid. You will lead rate terms, network participation, and renewal strategies to grow covered lives and protect margin for specialty pharmacy.

The role collaborates with trade relations, finance, and compliance, interfacing with external payer reps to secure expanded access and compliant contracts.

Qualifications

• Bachelor's degree required; MBA or graduate degree preferred.
• 5 years of payer contracting or managed care experience required.
• Experience negotiating payer or network agreements required.
• Knowledge of commercial, Medicare Part D and Medicaid payer environments.
• Certified Pharmacy Technician or related certification preferred.

Responsibilities

• Lead end-to-end payer negotiations including rate and term setting.
• Develop and execute a payer access roadmap for expanded contracts.
• Outreach to payers to identify credentialing and network requirements.
• Negotiate pricing and service agreements with payers per policy and compliance.
• Prepare documents for payer applications, contracts, and reviews.
• Track contracts through approval processes with stakeholders.
• Meet with payers to determine account management needs and ensure compliance.
• Recredential existing payer and government plans to maintain coverage.
• Coordinate contracts and data needs for master/service agreements.
• Develop relationships with payers and resolve claim/payment discrepancies.
• Ensure reporting and regulatory compliance across contracts.

Skills

Payer contracting

Managed care

Specialty pharmacy

Negotiation

Education

Bachelor's degree

MBA or graduate degree

Job description

Lumicera Health Services is seeking a Payer Contracting Executive to drive end-to-end payer negotiations across commercial, Medicare Part D, and Medicaid. You will lead rate terms, network participation, and renewal strategies to grow covered lives and protect margin for specialty pharmacy.

The role collaborates with trade relations, finance, and compliance, interfacing with external payer reps to secure expanded access and compliant contracts.