Pharmacy Payer Contract Analyst RX

Florida Cancer Specialists & Research Institute

Pharmacy Payer Contract Analyst RX

Fort Myers, FL
Paid
  • Responsibilities

    Fort Myers, FL (flexible work location)

    Work-From-Home Position

    Monday - Friday Work Week, Days (Example: 8:00 AM - 5:00 PM) Flexible to meet business needs

    Full-Time

    Travel Position


    Founded in 1984, FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE is the largest independent medical oncology/hematology practice in the United States. With over 200 physicians, based in 100+ locations across Florida, we are committed to providing world-class cancer care in community-based settings close to home.


    Our 3000+ team members enjoy:

    Competitive compensation

    COMPREHENSIVE BENEFITS PACKAGE INCLUDING:

    Medical, dental, vision, life, and disability insurance Paid time off Holiday pay Tuition reimbursement CEU hours 401(k) with company match


    POSITION SUMMARY

    The Pharmacy Payer Contract Analyst is responsible for supporting the Senior Director of Payer Relations and Business Development and the Pharmacy Compliance team.

    This role requires excellent administrative skills, including manipulation and utilization of computer software and typing, as well as understanding contracting, and compliance policies related to the pharmacy industry.

    Provides quantitative and qualitative analysis related to contracting. Maintain and model contracts for the purposes of monitoring contract performance and supporting negotiations.

    Maintain pertinent data tables, fee schedules, contract terms and contract rules necessary for contract modeling.

    Responsible for vetting, addressing and working with internal departments on resolving contracting related payer issues.

    POSITION REQUIREMENTS

    • EDUCATION: Bachelor’s Degree from a four-year university or higher; or equivalent experience.
    • PREVIOUS EXPERIENCE: Three (3) to 5 years cumulative experience in healthcare analytics working on either the provider or payer sides of health care preferred. In-depth knowledge of the healthcare industry including billing and claims, medical coding, payer/provider relations, contracting processes, fee schedules and reimbursement methodologies a plus.
    • CORE CAPABILITIES:
      • ANALYSIS & CRITICAL THINKING: Critical thinking skills including solid problem solving, analysis, decision-making, planning, time management and organizational skills. Must be detailed oriented with the ability to exercise independent judgment.
      • INTERPERSONAL EFFECTIVENESS: Developed interpersonal skills, emotional intelligence, diplomacy, tact, conflict management, delegation skills, and diversity awareness. Ability to work effectively with sensitive and confidential material and sometimes emotionally charged matters.
      • COMMUNICATION SKILLS: Effective communication skills (oral, written, presentation), is an active listener, and effectively provides balanced feedback.
      • CUSTOMER SERVICE & ORGANIZATIONAL AWARENESS: Strong customer focus. Ability to build an engaging culture of quality, performance effectiveness and operational excellence through best practices, strong business and political acumen, collaboration and partnerships, as well as a positive employee, physician and community relations.
      • SELF-MANAGEMENT: Effectively manages own time, conflicting priorities, self, stress, and professional development. Self-motivated and self-starter with ability work independently with limited supervision.
      • Must be able to work effectively in a fast-paced, multi-site environment with demonstrated ability to juggle competing priorities and demands from a variety of stakeholders and sites.
      • COMPUTER SKILLS:
        • Proficiency in MS Office Word, Excel, Power Point, and Outlook required.
        • Proficiency in all Pharmacy Software Programs and Practice Programs
    • CERTIFICATIONS/LICENSES:
      • Valid state Driver’s License for travel to satellite offices and offsite meetings. Compliance with the company Driver Safety Operations and Motor Vehicle Records Check Policy is required.
    • TRAVEL: 75%

    Note: Those who drive must provide copies of the declarations page of their personal insurance policy for each vehicle that they can use to the Human Resources Department for verification purposes annually. REQUIRED LIMITS: SPLIT LIMITS OF $100,000/$300,000/$100,000.

    18E

  • Industry
    Hospital and Health Care