Remote Payer Contracting Executive and Negotiations Lead

Lumicera; Richmond (VA); Remote; USD 120,000 - 180,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

Parental leave

401K match

Job summary

Lumicera Health Services is hiring a Payer Contracting Executive to grow payer access across commercial, Medicare Part D, and Medicaid opportunities. You will lead end-to-end negotiations, set renewal strategies, and manage provider network participation for specialty pharmacy services.

This role collaborates with legal, compliance, finance, and account teams to secure favorable terms and ensure contract adherence while expanding covered lives and protecting margins.

Qualifications

• Bachelor's degree required; MBA or graduate degree preferred.
• Experience in payer contracting, managed care, or specialty pharmacy is required.
• Experience negotiating payer or network agreements in specialty pharmacy or managed care contracting is required.
• Working knowledge of commercial, Medicare Part D, and Medicaid payer environments is required.

Responsibilities

• Lead payer negotiations end to end, including rate and term negotiation, network participation, and renewal strategy.
• Develop and execute a payer access roadmap for expanded contracts.
• Independently outreach to payers to identify credentialing and network requirements.
• Negotiate pricing and service agreements with payers and ensure contract compliance.
• Complete credentialing and new contract applications for payer and government clients.
• Track agreements through contracting with internal and external stakeholders.
• Meet with payer representatives to determine account management needs.

Skills

Payer contracting

Managed care

Specialty pharmacy

Negotiation

Relationship building

Education

Bachelor's degree

MBA or graduate degree

Tools

Credentialing

Network access knowledge

Job description

Lumicera Health Services is hiring a Payer Contracting Executive to grow payer access across commercial, Medicare Part D, and Medicaid opportunities. You will lead end-to-end negotiations, set renewal strategies, and manage provider network participation for specialty pharmacy services.

This role collaborates with legal, compliance, finance, and account teams to secure favorable terms and ensure contract adherence while expanding covered lives and protecting margins.