Contract Specialist - Pharmacy

Our team is seeking a hands-on team member with a passion for delighting customers, both external and internal. Your enthusiasm for your work shines through in all that you do. Your good nature and sense of humor is a plus.

In this role you will collaborate with internal colleagues and external stakeholders to analyze, manage and coordinate all financial and other information with third-party payor/insurance plans to ensure contract performance is optimized. You will coordinate the production and maintenance of payor contracts and related compliance and business/operations functions. You will analyze both existing and new business opportunities.

• Using pharmacy revenue management metrics and standard operating procedures, analyze proposed contracts, addendums and product lines for financial impact.
• Review, research and respond to payor issues for ambulatory pharmacy service line.
• Process improvement and trend analysis, quality assurance and research.
• Audit information submitted on the approved forms for document generation and load into Inmar and other management tools and systems.
• Maintain payor and contract data in contract tracking systems and databases to ensure data integrity.
• Coordinate and manage online payor documentation files including payor contract library.
• Responsible for all payor contract related program documentation.
• Support audits, compliance projects, process evaluation and improvement initiatives, and routine reporting.
• Update Contract Manager and other appropriate colleagues throughout the system of important developments, potential problems, and related information necessary for effective management and optimization of contract performance.
• Utilize contract templates and standard processes under the direction of Revenue Management, Contracting, Legal and Compliance departments.
• Maintain databases or potential, contracted, denied and other correspondence records for all related contracting opportunities.
• Maintain and update payor contact lists.

Education:

• Bachelors degree.

Experience:

• One year of experience in a pharmacy operation / business environment.

Preffered Experience:

• 2 years related experience. Preferably with insurance company/payor or health care provider system.
• Strong skills in Excel and other Microsoft Suite applications (PowerPoint, Visio, Word).

This position requires remote work. In addition to adhering to all M Health Fairview policies, guidelines, procedures, the M Health Fairview Commitments, and the Code of Conduct, it is the expectation the following requirements of the remote work policy will be met, including but not limited to:

• Remote workspace that is clean, safe,andprofessional.
• Maintains an internet connection consistent with Fairview standards at remote workspace.
• Remain productive and responsive during their scheduled work hours.
• Attend primary Fairview location, as needed.