Senior Payer Contracting Executive — Remote

Lumicera; Nashville (TN); Remote; USD 120,000 - 160,000; Full time

Benefits offered by this job

Health, Dental, Vision

Paid time off

Parental leave

401K match

Educational assistance

Job summary

Lumicera Health Services is seeking a Payer Contracting Executive to lead end-to-end negotiations across commercial, Medicare Part D, and Medicaid markets. The role focuses on expanding payer access, securing favorable terms, and protecting margins for the specialty pharmacy.

You will develop payer access roadmaps, identify non-participating networks, and coordinate with finance, legal, and compliance to ensure contracts meet regulatory standards.

Qualifications

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

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 and networks not currently in network.
• Outreach to payers to identify credentialing and network requirements and pursue new access opportunities.
• Establish, monitor, and negotiate pricing and service agreements with payers in compliance with company policy.
• Complete credentialing and new contract applications for payer and government clients; prepare supporting documents for reviews.

Skills

Payer contracting

Negotiation

Managed care

Specialty pharmacy

Compliance

Education

Bachelor's degree

MBA

Job description

Lumicera Health Services is seeking a Payer Contracting Executive to lead end-to-end negotiations across commercial, Medicare Part D, and Medicaid markets. The role focuses on expanding payer access, securing favorable terms, and protecting margins for the specialty pharmacy.

You will develop payer access roadmaps, identify non-participating networks, and coordinate with finance, legal, and compliance to ensure contracts meet regulatory standards.