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Advisor, Network and Payor Relations

Advisor, Network and Payor Relations

Boston StaffingBoston, MA, US
Hace 5 días
Tipo de contrato
  • A tiempo completo
Descripción del trabajo

Marketing Network And Payor Relations Advisor

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.

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).

Responsibilities :

  • 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.

What is expected of you and others at this level :

  • 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.
  • Works on complex projects of large scope.
  • Develops technical solutions to a wide range of difficult problems.
  • Solutions are innovative and consistent with organization objectives.
  • Completes work independently; receives general guidance on new projects.
  • Work reviewed for purpose of meeting objectives.
  • May act as a mentor to less experienced colleagues.
  • 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.
  • Anticipated pay range : $67,500-$86,670. Bonus eligible : Yes.

    Benefits :

  • 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.
  • Application window anticipated to close : 12 / 27 / 2025. If interested in opportunity, please submit application as soon as possible.

    The salary range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity.

    Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

    Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day.

    Cardinal Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity / expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.

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