Responsibilities include establishing specialty pharmacy payor contracts on behalf of partnering health care hospital systems.

Manage the Specialty Pharmacy, Home Infusion and Infertility Pharmacy provider networks across all lines of business (Commercial, Medicaid and Medicare). Manage direct drug rebate agreements with manufacturers and third party vendors. Maintain industry specific knowledge and relationships with key providers and industry related groups.

Contract Manager for Medicare Advantage and Medicaid dual eligible products, in the Network Contracting and Performance Management department, primary point of contact with providers to negotiate contracts with network physicians and hospitals. Primary lead during negotiations and accountable for the financial and legal terms negotiated with the providers. Familiar with Medicare reimbursement methodologies and risk based agreements. Ensure that contract terms are consistent with the contracting strategy and are negotiated within the established legal and financial guidelines as established by the Plan and as required by CMS. Engage and communicate to key internal stakeholders including Case Management and Risk Adjustment teams. Successfully negotiate and transition agreements for implementation.

Initiate and successfully lead negotiations with large volume hospitals in the Rhode Island market. Managed all facets of contractual relationships with designated hospitals for United Healthcare’s commercial, Medicare Advantage and Medicaid networks. Developed and executed negotiation strategies that directly impacted financial performance. Took lead and supporting role with providers and engaged internal stakeholders in contractual language and financial negotiations with assigned hospitals. Lead and facilitated Joint Operation Committee meetings between United Healthcare and assigned hospitals.