Remote Payer Contracting Executive: Expand Access & Margin

Lumicera; Indianapolis (IN); Remote; USD 120,000 - 180,000; Full time

Benefits offered by this job

Health benefits

Paid time off

Parental leave

Paid holidays

401K matching

Adoption assistance

FSA

Educational assistance

Referral bonus

Job summary

Lumicera Health Services is seeking a Payer Contracting Executive to expand payer access across commercial, Medicare Part D, and Medicaid opportunities. The role leads end-to-end payer negotiations, including rate and term negotiations, network participation, performance-guarantee structures, and renewal strategy to grow covered lives and protect margin for the specialty pharmacy.

The Payer Contracting Executive collaborates with trade relations, account management, finance, legal, and

Qualifications

• Bachelor's degree required; MBA preferred.
• 5 years in payer contracting, managed care, or specialty pharmacy.
• Experience negotiating payer or network agreements in relevant environments.
• Knowledge of commercial, Medicare Part D, and Medicaid payer rules.
• Certification in pharmacy or related field preferred.

Responsibilities

• Lead end-to-end payer negotiations, including rates and terms.
• Develop payer access roadmaps and expand in-network opportunities.
• Outreach to payers to identify credentialing and access needs.
• Negotiate pricing and service terms with payers with compliance oversight.
• Prepare credentialing, applications, and supporting documents.
• Track contracting progress and communicate with stakeholders.
• Meet payer reps to define account management needs and ensure compliance.
• Recredential existing payer/government plans and monitor coverage.
• Coordinate contracts and data needs for master/service agreements.
• Develop payer relationships and resolve discrepancies in payments.

Skills

Payer contracting

Managed care

Specialty pharmacy

Education

Bachelor's degree

MBA (preferred)

Certified Pharmacy Technician (preferred)

Job description

Lumicera Health Services is seeking a Payer Contracting Executive to expand payer access across commercial, Medicare Part D, and Medicaid opportunities. The role leads end-to-end payer negotiations, including rate and term negotiations, network participation, performance-guarantee structures, and renewal strategy to grow covered lives and protect margin for the specialty pharmacy.

The Payer Contracting Executive collaborates with trade relations, account management, finance, legal, and