Provider Contracting Director is responsible for the operations of the provider contracts department. Ensures that provider contracts are processed to support accurate and efficient claims payments. Being a Provider Contracting Director oversees the formulation of provider contracts and specific terms. Analyzes contract data and provides financial projections. Additionally, Provider Contracting Director requires a bachelor's degree. Typically reports to top management. The Provider Contracting Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Provider Contracting Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)
Putting People First in Pharmacy- Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other.
Due to growth, we are adding a Sr. Analyst, Network Contracting to our Provider Services Department.
We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.
The Senior Analyst, Network Contracting will be responsible for the financial management of retail, specialty, and mail order pharmacy contracting, issue management, and reporting, in support of the network strategy to deliver value to Navitus clients. The primary responsibilities of this role are to analyze current and new pharmacy contracts and provide support for all phases of the pharmacy contracting process, including national and regional chain providers, pharmacy services administration organizations (PSAOs) and independent pharmacies for all lines of business.
The Network Contracting Senior Analyst will analyze contract alternatives to support Network Contracting retail and specialty teams and lead analysis of negotiated contracts to maximize return and mitigate risks. The Network Contracting Senior Analyst will provide clear data summaries to explain reimbursement, network needs, and industry trends to support pharmacy and vendor contract negotiations across all lines of business and geographies (Commercial, Medicare and managed Medicaid). This position will be expected to work cross functionally with internal and external partners including clients, vendors, and pharmacy partners to deliver value to Navitus clients through our pharmacy contracts.
Is this you? Find out more below!
How do I make an impact on my team?
What our team expects from you?
What can you expect from Navitus?
Clear All
0 Provider Contracting Director jobs found in Appleton, WI area