Shields Health Solutions is hiring a
Contracting Analyst

Summary

Join a fast-growing company in the Healthcare Services sector as a Payor Access / Contracting Analyst. This role involves numerous workflows related to establishing and maintaining specialty pharmacy payor contracts on behalf of partnering health systems.

Requirements

• Experience with pharmacy claims, pharmacy benefit plans (BIN/PCN/Group), specialty medications, and specialty pharmacy clinical and operational care models
• Ability to communicate results in a clear and concise manner via Excel tables, email communication, and PowerPoint slides
• Exceptionally organized and data driven
• Comfortable and successful handling numerous concurrent work streams

Responsibilities

• Play a key role the assessment and fulfillment of clinical and operational reporting requirements mandated by payor and PBM networks
• Participate in the preparation and submission of applications related to specialty network access on behalf of Shields partners
• Conduct primary and secondary research in support of the contracting process; with a focus on payor access and specialty formularies
• Perform investigative research into pharmacy network access at the BIN/PCN/Group level; inclusive of running test claims and other data-driven methods
• Support workstreams related to state licensing matters, including new applications, credentialing, and re-credentialing
• Independently manage numerous workstreams related to contracting and payor access
• Provide exceptional and timely customer service to our partners on all matters related to contracting and payor access
• Identify solutions to non-standard requests and problems
• Willingness to do whatever is necessary for the betterment of the Company
• Protect organization's value by keeping information confidential
• Other duties as assigned

Preferred Qualifications

Project management and/or, healthcare contracting experience; clinical, pharmacy, 340B, or pharmacy benefit management knowledge