Healthcare Contracts Manager at MATTRESS FACTORY

Seattle, Washington, United States -

Full Time

Start Date

Immediate

Expiry Date

29 Apr, 26

Salary

0.0

Posted On

29 Jan, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Negotiation, Contract Management, Healthcare Regulations, Reimbursement Models, Analytical Skills, Communication, Relationship Building, Organization, Payer Outreach, Business Development, 340B Program, Pharmacy Contracting, Coding Standards, Compliance, Financial Analysis, Microsoft Office

Industry

Wellness and Fitness Services

Description

About the role The Healthcare Contracts Manager plays a key role in advancing the organization’s mission by leading the negotiation, development, and management of payer contracts, collaborative agreements, and service partnerships with healthcare entities. This position will collaborate with executive leadership, finance, and clinical teams to develop and maintain contracting strategies that drive organizational growth, optimize reimbursement for high-cost therapies, and secure favorable terms for new service lines or partnerships, operational effectiveness, and high‑quality care delivery across the organization’s programs. Job Duties Proactively identify and pursue opportunities to establish and maintain payer contracts, network inclusions, and partnerships with commercial insurers, PBMs, medical coverage plans, self-insured employers, and local businesses to expand WACBD's in-network provider status and increase patient access/revenue streams. Lead negotiation, drafting, execution and maintenance of payer contracts Oversee proper entry of contract rates into organizational databases and ensure they are securely maintained. Analyze contract terms, reimbursement methodologies, and regulatory requirements to ensure alignment with organizational goals and compliance standards. As needed, aid the Pharmacy Director to review and negotiate contracts related to 340B pharmacy operations, including specialty pharmacy distribution, replenishment models, and third-party arrangements. Manage and update office of Pharmacy Affairs 340B Database. Develop and manage collaborative agreements, MOUs, and service contracts with hospitals, clinics, community partners, and other healthcare and community organizations. Ensure all contracts adhere to federal and state regulations, including 340B, HIPAA, Medicaid/Medicare requirements, and Washington State healthcare laws. Partner with clinical, pharmacy, finance, compliance/legal, and administrative teams to understand operational needs and translate them into effective contract structures. A full job description will be made available to candidates before they interview with the hiring manager Qualifications Bachelor’s degree in a related field, or equivalent combination of education and experience 3–5+ years of experience in negotiating complex agreements with payers, PBMs, and healthcare vendors Strong understanding of Washington State healthcare regulations, reimbursement models, managed care structures, and healthcare regulatory requirements Thorough knowledge of Medicare, Medicaid and other governmental insurance regulations and CMS claims form Strong command of current coding standards (CPT, HCPCS, ICD-10) and their impact on reimbursement modeling Ability to interpret complex contract language and translate it into operational requirements Excellent negotiation, communication, and relationship building skills Strong organization skills Preference for experience in proactive payer outreach, network expansion, or business development in specialty/rare disease healthcare. Proven success building and closing complex PBM or payer contracts. Understanding of 340B program requirements and pharmacy contracting preferred Exceptional analytical skills, mathematical/accounting ability sufficient to support the management of the insurance billing and accounting systems Ability to maintain confidentiality per HIPAA requirements Experience with Microsoft office/365 Experience with Hemophilia Treatment Centers (HTC) or high-cost specialty pharmacy contracting is a plus.

Responsibilities

The Healthcare Contracts Manager leads the negotiation, development, and management of payer contracts and service partnerships with healthcare entities. This role collaborates with various teams to optimize reimbursement and secure favorable terms for new service lines.