Payer Contracting Manager, Home Infusion - Evernorth - Remote
Core
Build and maintain a knowledge base of home infusion contract reimbursement information and advise health system partners on payer contracts, rates, and implementation strategies.
Role type
Senior Payer Contracting Manager (Home Infusion)
Builds
Optimized payer contracts and reimbursement strategies for home infusion pharmacy services
Domain
Healthcare / Specialty Pharmacy / Managed Care
Deliverable
production ML models | product features | dashboards & analysis | client delivery
Required skills
Payer contract management, rate benchmarking analysis, health insurance plan knowledge (MCO, PPO, POS, TPAs), healthcare billing and reimbursement regulations, strategic partnership building, cross-functional coordination
Preferred skills
CPR+, CareTend, HCN EMR systems experience
Technologies
Microsoft Excel, Microsoft Word, Microsoft PowerPoint
Responsibilities
Develop payor priorities for securing contracts, review and analyze proposed rates against benchmarks, guide health system implementation of home infusion pharmacy, maintain knowledgebase of benchmark rates and managed care terms, oversee payer change management strategy, serve as trusted advisor to client executives
Seniority
Senior, hands-on IC
