Provider Contracting Manager manages the activities of the contracting staff that prepare and maintain contracts and the contracts database system for a health plan network. Responsible for negotiating with facilities joining the health network and setting rates. Being a Provider Contracting Manager oversees network reporting requirements to ensure compliance with regulatory agencies, and to produce accurate and relevant reporting of data. Trains and develops staff. Additionally, Provider Contracting Manager requires a bachelor's degree. Typically reports to a head of a unit/department. The Provider Contracting Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Provider Contracting Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)
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POSITION SUMMARY
The Provider Contracting Senior Advisor provides strategic support to the negotiations team for a number of assigned pharmaceutical manufacturer accounts. Responsibilities include: contract review and interpretation, review and negotiate redlined agreements, finalizing matrices, strategic business review and participation in strategic initiatives. Understanding the financial impact of assigned accounts is critical. The position will align to the Director of Account Management. This position will work closely with various matrix partners, including legal/contracting, invoicing, rebate optimization, and formulary teams.
ESSENTIAL FUNCTIONS
QUALIFICATIONS
ABOUT THE DEPARTMENT
The Pharma Strategy & Contracting team plays a key role in keeping us at the forefront of healthcare evolution. Team members are tasked with overseeing partnerships with brand pharmaceutical manufacturers, one of Express Scripts’ key supplier groups. Successfully maintaining these relationships allows our 83 million patients to have access to the medicine they need at a price they can afford.
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