Contracting and Pricing Director for Managed Care

1 week ago

Miami, United States Nicklaushealth Full time

As a Contracting and Pricing Director at the Academy of Managed Care Pharmacy, you will play a pivotal role in shaping the future of healthcare contracting and pricing strategies. With our organization's commitment to excellence in managed care pharmacy, we are seeking a skilled professional to lead our team in navigating the complexities of the ever-evolving payer landscape.

Job Summary

This leadership position requires a seasoned expert with 7-10 years of experience in hospital and/or payer negotiations and analysis. You will be responsible for guiding Senior Leadership on aspects of payer contracting/negotiations, pricing, and delegated credentialing. Your expertise will help us adapt to an ever-changing payer environment, ensuring seamless operations and driving growth through strategic partnerships.

The ideal candidate will possess a deep understanding of health care industry dynamics, market trends, competitors, regulations, and payer environments. Strong business acumen, financial skills, and exceptional communication abilities are essential in this role. If you're a results-driven leader with a passion for managing complex projects and teams, we encourage you to apply.

Key Responsibilities:
  • Detailed understanding of health care industry, market dynamics, trends, competitors, regulations, and payer environment.
  • Collaboration with management team and all departmental levels on both hospital and physician sides to ensure operational issues are addressed and remedied.
  • Creation and maintenance of professional relationships with payers and potential affiliates.
  • Analysis and interpretation of financial reports to support payer negotiations, trends, and audit.
  • Implementation and communication of contracting strategies in collaboration with Senior Leader.
  • Management of all out-of-network contracting for both hospital and employed physicians.
  • Development and management of subordinates.
Requirements:
  • Bachelor's Degree in Business Administration or Health Management.
  • 4-7 years of management experience in the healthcare finance/payer/managed care contracting field.
  • 7-10 years of hospital and/or payer negotiations and analysis experience.

We offer a competitive salary range of $120,000 - $160,000 per year, commensurate with experience. Located in Miami, Florida, at our NCHS Corporate Headquarters, you will join a dynamic team dedicated to excellence in managed care pharmacy.

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