Remote Utilization Contract Administrator

JobDiva, Inc.; Harmonville (PA); Remote; USD 76,000 - 90,000; Full time

Job summary

Primary Talent Partners is seeking a Remote Utilization Contract Administrator in the United States for a 7-month contract, with extension potential. The role covers contract adjudication, analysis, and coordination for Managed Care customers, including Health Plans, PBMs, and hospitals.

The ideal candidate will ensure compliance with contract terms and regulatory requirements while delivering accurate discount calculations, rebates, and government pricing program alignment.

Qualifications

• Bachelor's degree or equivalent experience in business, finance, legal studies, healthcare administration, or related field.
• 3–5 years of experience in pharmaceutical contracting, specifically utilization-based contract compliance and administration.
• Experience with US pricing and reimbursement within managed care contracting.

Responsibilities

• Collaborate with internal and external teams to research membership and eligibility inquiries, driving toward compliant resolution.
• Conduct formal contract reviews to identify risk and feasibility of operationalizing contracting language.
• Interpret contracting language to ensure alignment with system capabilities.
• Oversee contract administration tasks performed by third-party vendors and monitor accuracy.
• Support rebate payment processing and data validation for diverse customer bases.
• Develop compliant data management and contract operations processes.
• Contribute to external reporting through critical control activities and analyses.
• Support team projects and training initiatives within US Market Accounts Management.

Skills

Managed care contracting

Pricing & reimbursement knowledge

Market access contracting

Contract operations systems

Clear written & verbal communication

Attention to detail

Prioritization

Relationship building

Education

Bachelor's degree in Business/Finance/Legal Studies/Healthcare Administration

Equivalent experience considered

Job description

Primary Talent Partners has a new contract opening for an Remote Utilization Contract Administratorto join a global health care company in Plymouth Meeting, PA. This is a 7-month contract to start with the potential for extensions.

Pay: $55.20 - $65.17/hr;W2 contract, no PTO, no Benefits. ACA-compliant supplemental package available for enrollment.Candidates must be legally authorized to work in the United States and must be able to sit on Primary Talent Partners W2 without sponsorship.

Schedule:Core working hours are 8am-5pm; with ability to Flex by adding 1-2 hour M-Th to take Friday afternoons off.

Description:

The Contract Operations Sr. Specialist – US Market Access Contract Operations is responsible for contract adjudication, analysis, and coordination activities in support of Managed Care customers. This position will support company’s contracted customers including but not limited to Health Plans, Pharmacy Benefit Managers, Hospital and IDN customers and will require robust technical skills, business, and financial acumen. The highest level of compliance with contract terms and conditions, regulatory requirements, and laws is required, while also striving for strong business partnership and customer transaction excellence.

The ideal candidate will support our customers and Third-Party agents in the implementation, administration, and performance reporting for specific customer agreements entered into by Market Access and Account Management that involve discounts, rebates, and other payments based on the purchase and use of products. This includes, but is not limited to, ensuring the accuracy of calculated discounts as well as compliance of contract terms and conditions, including mandated Government Pricing Programs.

Primary responsibilities include and are not limited to the following:

• Collaborate with internal and external teams to research membership and eligibility inquiries, driving toward compliant resolution.
• Conduct formal contract reviews to identify risk and feasibility of operationalizing contracting language in an evolving healthcare system.
• Understand and interpret contracting language to identifying potential misalignments with current system capabilities.
• Oversee and guide contract administration tasks performed by third-party vendor, proactively monitoring for accuracy and completeness.
• Support contract administration and rebate payment processing for a diverse range of customers, including validation of data and assessment of customer compliance with contract terms.
• Create and maintain compliant processes for effective data management and contract operations.
• Support the company's external reporting through critical control activities and analyses.
• Contribute to the broader US Market Accounts Management team project portfolio, including implementation of and contributions to the team's best practices and training initiatives.
• Uphold high standards of quality and accuracy in all technical work.

Qualifications:

• Bachelor's degree in Business, Finance, Legal Studies, Healthcare Administration, or related field.
• Extensive working knowledge and experience in lieu of a degree will be considered.
• 3-5 years of experience in pharmaceutical contracting, specifically Utilization-based contract compliance and administration

Experience and Skills:

• Managed care contracting expertise
• Experience with pricing and reimbursement in US
• Pharmaceutical market access contracting knowledge; terms and conditions, impact of language on outcomes
• Working knowledge of pharmaceutical contract operations systems and end-to-end processes
• Clear, concise, and direct written & verbal communication
• Consistency and high attention to detail
• Ability to effectively prioritize workload
• Ability to build strong customer and internal relationships at all levels

Preferred Skills:

• Broad understanding of US Health Care and product contracting environment
• Preferred: knowledge of Purchase-based contract compliance and administration

NOTES:

• Position: 2
• Remote

Primary Talent Partners is an Equal Opportunity / Affir

If you are a person with a disability needing assistance with the application or at any point in the hiring process, please contact us at [e-mail]

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