Advisor, Network and Payor Relations

Marketing Function At Cardinal Health

At Cardinal Health, the marketing organization is the central hub of business driving activity. Marketing takes the lead on all aspects of the marketing mix product, price, place, people and promotion. Marketing analyzes customer behavior to understand their needs, and motivations, broadly defines and communicates the brand purpose and passionately delivers total solutions for our customers.

Role Expectations

The Network and Payor Relations Advisor is responsible for the development and management of business relationships with Pharmacy Benefit Management (PBM) companies and Health Plans. Responsibilities include contracting activities with an emphasis on contract compliance and management of contract performance for Cardinal Health and its Pharmacy Services Administrative Organizations (PSAOs).

Demonstrates knowledge of network and payor concepts necessary to ensure contract compliance. Has the ability to understand managed care trends and competitive positioning. Exhibits strong financial acumen and logical decision-making skills in the general business environment. Validates managed care contracts through review and understands and demonstrate sound thought processes as they relate to reimbursement methodologies. Effectively develops and maintains high level relationships with Pharmacy Benefit Managers (PBMs), the Network, and other managed care vendors. Exhibits an ability to translate market and customer needs into clearly defined goals, objectives, strategies, and tactics to drive sales and profitability for the business. Accountable for gaining and driving cross functional support from all stakeholders. Understands methods available to execute primary research necessary to drive business decisions. Can identify market opportunities through analysis of network performance and compliance, taking action to implement and manage solutions that meet customer needs. Understands the regulatory environment surrounding payor relations, reimbursement, and health policy. Works effectively across cross functional groups including but not limited to IT, communications, operations, sales, and finance. Applies comprehensive knowledge and a thorough understanding of concepts, principles, and technical capabilities to perform varied tasks and projects. May contribute to the development of policies and procedures. May act as a mentor to less experienced colleagues. Completes work independently; receives general guidance on new projects.

Monitor reimbursement trends and claim-level data to identify underpayments or systemic payor issues. Act as liaison and pharmacy advocate for all escalated issues within the Managed Care department. Complete thorough business review of each PBM contract to drive education and contract compliance for the PSAO and membership.

Qualifications

Bachelor's degree preferred or equivalent work experience. 5 years of experience preferred. Strong communication and analytical skills preferred. Extensive understanding of Managed Care, PBM networks and Pharmacy industry trends preferred. Must have experience with Microsoft Office (Word, Excel, and Power Point specifically). Previous pharmacy experience is a plus. PSAO / Managed Care experience is a plus.

Compensation and Benefits

Anticipated pay range : $67,500-$86,670 (includes targeted variable pay) Bonus eligible : Yes Benefits : Cardinal Health offers a wide variety of benefits and programs to support health and well-being. Medical, dental and vision coverage Paid time off plan Health savings account (HSA) 401k savings plan Access to wages before pay day with myFlexPay Flexible spending accounts (FSAs) Short- and long-term disability coverage Work-Life resources Paid parental leave Healthy lifestyle programs