Payor Contracts Associate bei None

Job Summary:

The below is intended to describe the general content of and requirements for the performance of this job and is not to be construed as an exhaustive statement of essential functions, responsibilities, or requirements. Under the guidance of the Payor Contract Manager, this position is responsible for managing contract lifecycle activities, monitoring reimbursement issues, maintaining contract documentation, and supporting pricing and claim resolution efforts. The ideal candidate is detail-oriented, highly organized, and possesses a strong understanding of medical and pharmacy payor contracting.

Primary Duties and Responsibilities

· Provide day-to-day support to the reimbursement team by assisting in the resolution of claim disputes, pricing discrepancies, and other payor-related issues.

· Maintain and update contract databases, ensuring all contract amendments, renewals, and key terms are accurately tracked.

· Ensure reimbursement dashboards and related data reports are current and accurately reflect contract status.

· Organize and manage contract-related documentation and correspondence in accordance with compliance and recordkeeping standards.

· Monitor the status of open reimbursement requests, follow up regularly, and help drive issues toward timely resolution.

· Track the lifecycle of payor contracts, including Letters of Agreement (LOAs), amendments, and renewals, ensuring all are executed in a timely manner.

· Collaborate cross-functionally with internal teams to ensure contract alignment with operational needs.

• Lead the coordination of contract implementation efforts, ensuring internal stakeholders are informed and aligned on contract provisions and updates.
• Exercise discretion and independent judgment in prioritizing contract escalations and resolving complex reimbursement issues
• Serve as a subject matter expert on contract processes with each payor
• Analyze payor contracts and reimbursement terms to identify risks provide summaries

Minimum Knowledge, Abilities, and Skills Required

1. Education: Bachelor' s Degree in related field preferred. In lieu of degree, high school diploma or GED and 5+ years of relevant experience.
2. Required years of experience: 3 years of relevant experience including medical and pharmacy contracting
3. Other related minimum expectations: Proficient in all Microsoft Office applications a
4. Complies with accepted professional standards and practice.
5. Highly organized with strong attention to detail
6. Team-oriented and able to work effectively cross-functionally
7. Demonstrates excellent observation, verbal and written communication skills.