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Senior Director, Payer Programs and Operations

2 months ago

Bentonville, Arkansas, United States Walmart Full time
About the Role

This is a senior leadership position responsible for overseeing the coordination of strategic negotiation planning, including conducting industry and payer research, supporting retail and specialty pharmacy negotiations, and new business development.

Key Responsibilities
  • Directs teams in the coordination of implementation activities for new accounts and/or large-scale upgrades to existing accounts.
  • Coordinates with the broader Health and Wellness business unit when required.
  • Oversees a team that provides customer support during the implementation process.
  • Ensures that all stakeholders are kept informed regarding project status and progress.
  • Captures best practices from successful implementations and applies to other accounts, implementations, or contract negotiations.
Additional Responsibilities
  • Directs implementation of core payer program processes by overseeing negotiations and re-negotiations of contractual programs.
  • Executes additional implementation and post-implementation requirements.
  • Identifies opportunities to streamline or improve the implementation and post-implementation processes.
  • Directs quality assurance processes and work flows by creating and maintaining quality assurance processes and procedures.
  • Establishes system checks to ensure accuracy of eligibility and billing systems.
Requirements
  • Bachelor's degree and 6 years' experience in billing, healthcare, legal, or related area.
  • 8 years' experience in billing, healthcare, legal, or related area.
  • 3 years' supervisory experience.