Contract Coder Jobs in Holmdel, NJ (NOW HIRING)

JOB SUMMARY

This job serves as the primary point of contact within the Highmark Pharmacy Services organization responsible for the negotiation of pharmacy and applicable vendor contracts and resolution of related contract matters. The incumbent collaborates directly with internal and external legal counsel and vendor legal counsel teams (e.g., Pharmacy Benefit Manager, Specialty Pharmacy) to manage the end-to-end contract lifecycle, including contract renewals, negotiations, terminations and amendments as needed by the business. In the course of managing the portfolio of pharmacy and applicable vendor contracts, the incumbent interfaces with other organization stakeholders in order to maximize value and mitigate risk to the organization. In addition, the incumbent partners directly with the Pharmacy Services leadership team on contracting initiates related to specific team business needs in support of the overall organization's strategic pharmacy contracting portfolio. Other related job functions include the identification and interpretation of relevant contract language, responding to contract disclosure requests to support external audit activities, contract maintenance and storage, support of pharmacy and related RFPs and leading/facilitating contract discussions with other members of the Pharmacy Services team and others teams outside of Pharmacy Services. In addition, the incumbent may provide guidance or expertise to other analysts and stakeholders within the Pharmacy Services organization during collaborative contract-related initiatives.

ESSENTIAL RESPONSIBILITIES

• Manage pharmacy contracts including contract development, negotiation, renewal, termination, execution and hard copy/electronic storage with minimal supervision/direction.
• Collaborate directly with internal, external, and vendor legal counsel teams (e.g., Pharmacy Benefit Manager, Specialty Pharmacy) during the contract negotiation process, up to and including the point of contract execution.
• Interface with the Organization's stakeholders in the management of the pharmacy and vendor contract portfolio in order to maximize value and mitigate risk to the organization.
• Partner directly with the Pharmacy Services leadership team on contracting initiatives related to specific team business needs in support of the overall organization's strategic pharmacy contracting portfolio.
• Provide guidance or expertise to other analysts and stakeholders within the Pharmacy Services organization during collaborative initiatives.
• Addresses, investigates and resolves pharmacy contract matters / issues, post contract execution.
• Other duties as assigned.

EDUCATION

Required

• Bachelor's Degree in Business Administration/Management or five years of relevant experience and/or education as determined by the company in lieu of bachelor's degree

Preferred

• Doctorate in Law

EXPERIENCE

Required

• 5 - 7 years of Contract Development Experience
• 5 - 7 years of Contract Management Experience

Preferred

• 7 - 10 years of Healthcare Industry Experience
• 7 - 10 years of Managed Care
• 7 -10 years of Pharmacy Benefit Management Experience

LICENSES OR CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Written & Oral Presentation Skills
• Communication Skills

Language (other than English)

None

Travel Requirement

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-Based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Does Not Apply

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Frequently

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Does Not Apply

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

Pay Range Maximum:

Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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