Job Description

Department:

13385 Enterprise Corporate - Managed Health Payor Contracting

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

This position will focus on payor contracting for retail and specialty pharmacies for the Enterprise.

Due to complex requirements, remote work is NOT permitted in: CA, DC, CO, CT, HI, MA, MD, MN, ND, NJ, NY, OR, RI, VT, WA and working Internationally.*

Pay Range:

$75.40 - $120.65

Essential Functions

• Leads team to meet the managed care contracting objectives of MHR and the System.
• Ensures appropriate negotiation planning is completed and presented.
• Develops contracting strategy to support the growth of the System through meeting the critical needs of affiliate facilities as well as supporting operational changes within owned facilities.
• Ensures MHR team members negotiates appropriate contract rates and language within established deadlines with financial results that meets or exceeds net revenue budgets and net margin targets to support the mission of the System.
• Provides the System with accurate and current managed care market intelligence; maintains a working understanding of local/regional/national trends, conducts competitive market assessments, changes and impact of regulatory environment, changes and impact of payor initiatives and provides other information to support MHR and the System initiatives.
• Ensure Managed Care Analytics team members accurately and timely completes all required analyzes and contract modeling to support Managed Care Contracting and Payor Relations activities.
• Oversees the development and delivery of standard contract metrics, reporting frequency, and delivery of Executive Summary report to measure portfolio performance.

Physical Requirements

Performs most work under normal office conditions. May include sitting for long periods, standing, driving, walking. Intact sight and hearing with or without assistive devices required. Require frequent verbal and written communications in English to payors, teammates, physicians, and others throughout the System.

Education, Experience and Certification

Master's Degree required (MBA or MHA); Bachelor's Degree with comparable senior-level experience may be considered. Minimum seven years of contract negotiation experience required, or 10 years of combined provider and/or payor contracting experience. Must have a proven record of closing negotiations on time and at or above budget expectations, with demonstrated experience negotiating retail and specialty pharmacy contracts, including payer, PBM, specialty pharmacy, and retail network arrangements. Experience working for a pharmaceutical company or within the pharmacy services function of a multi-entity health system preferred.

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job
• Incentive pay for select positions
• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.

About Advocate Health

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.