Directs the enterprise payor contracting strategy for an infusion pharmacy organization
Ensures that standardized and approved processes are utilized for payor relationship management, contract negotiation, network participation strategy, and reimbursement optimization across commercial, Medicare, Medicaid, and employer-sponsored plans
Develops and leads a comprehensive contracting strategy aligned with growth goals across home infusion, ambulatory infusion centers (AICs), and site-of-care optimization strategies within the medical benefit
Serves as a strategic advisor to executive leadership on health plan contracting trends, medical benefit reimbursement risk, site-of-care shifts, and evolving regulatory/CMS considerations impacting infusion services
Leads complex negotiations with national and regional health plans and government payors
Oversees contract modeling, financial impact analysis, approval governance, and ongoing performance monitoring
Partners with finance, operations, and clinical teams to evaluate reimbursement methodologies
Acts as the primary liaison between contracting and internal stakeholders
Leads, mentors, and develops a team of payor contracting professionals and contract managers
Ensures contracting activities align with federal and state regulations, CMS requirements, and health plan audit expectations

Requires a Bachelor’s degree
Minimum of 10 years of progressive experience in payor contracting, reimbursement, or managed care within specialty pharmacy, infusion services, PBM, or health plan environments
Demonstrated success leading complex national and regional negotiations
Proven people leadership experience

Director of Payor Contracting – Infusion

Key skills