Payor Contracts Manager

Why Join Omnicell?

At Omnicell, we are transforming the future of pharmacy care through innovation, operational excellence, and deep partnerships across the healthcare ecosystem. As a Payor Contracts Manager, you will play a critical role in enabling access, improving reimbursement outcomes, and strengthening pharmacy network performance through strategic payer and PBM partnerships.

This is an opportunity to lead impactful contract negotiations, influence network growth, and collaborate cross-functionally with legal, finance, and pharmacy operations teams. If you thrive in a fast-paced, data-driven environment and want to make a measurable impact on pharmacy access and performance, this role offers both challenge and growth.

What You’ll Do (Key Responsibilities)

Primary Impact:
Drive the successful negotiation, implementation, and optimization of PBM and payer contracts to ensure strong pharmacy network participation, regulatory compliance, and financial performance.

As a Payor Contracts Manager, you will:

Lead Contract Strategy & Negotiation

• Lead negotiations of PBM and payer contracts, driving favorable business terms and sustainable pharmacy network participation
• Partner with internal stakeholders to execute, administer, and optimize contract performance across the lifecycle
• Oversee contract amendments, renewals, and terminations to ensure compliance with contractual obligations and timelines
• Maintain clear and accurate contract documentation and communicate key terms to stakeholders
   

Enable Pharmacy Network Participation

• Facilitate onboarding, participation, and offboarding of independent pharmacies within payer and PBM networks
• Ensure alignment between pharmacy eligibility requirements and network participation criteria
• Maintain accurate participation records and collaborate with pharmacy relations teams to resolve issues impacting pharmacy access
   

Operationalize PBM & Payor Contracts

• Interpret contract provisions and translate them into actionable operational requirements
• Ensure accurate implementation of reimbursement structures, participation rules, and network requirements
• Monitor and track contractual obligations and key deliverables across PBM and payer relationships
   

Ensure Compliance & Mitigate Risk

• Ensure adherence to regulatory requirements, contractual obligations, and payer policies
• Support internal and external audits related to PBM/payer contracts and pharmacy network participation
• Identify compliance risks and proactively escalate and resolve issues
   

Optimize Reimbursement Performance

• Lead resolution of complex reimbursement and claims issues, including reprocessing and negotiated adjustments
• Partner with finance and operational teams to ensure payment accuracy and reconciliation
• Develop strategies to maximize reimbursement outcomes for participating pharmacies
   

Drive Cross-Functional Collaboration

• Serve as a key liaison between contracting, pharmacy relations, legal, and finance teams
• Provide operational insights to support contract negotiations and network strategies
• Build strong partnerships to align contract execution with business objectives
   

Leverage Data & Insights

• Analyze trends related to reimbursement, claim rejections, and network performance
• Develop and deliver reporting on: 
  • Pharmacy network participation
  • Contract lifecycle and renewals
  • PBM participation and performance metrics
  • Compliance tracking and audit readiness
• Provide actionable insights and recommendations to senior leadership
   

Champion Process Improvement

• Identify and implement scalable processes to support expanding pharmacy networks
• Enhance contract tracking systems and participation monitoring tools
• Drive continuous improvement initiatives to increase efficiency and accuracy in contract administration
   

Who You Are (Qualifications & Skills)

Minimum Qualifications

• 5+ years of experience in healthcare contracting, PBM contract administration, pharmacy network operations, or PSAO environments
• Strong knowledge of PBM contracts, payer networks, reimbursement methodologies, and regulatory requirements
• Negotiation skills with the ability to influence internal and external stakeholders
• Strong analytical, problem-solving, and organizational skills with high attention to detail
• Proficiency in Microsoft Office tools (especially Excel) and familiarity with pharmacy or credentialing systems
   

Preferred Qualifications

• PSAO knowledge and experience
• Experience with specialty pharmacy operations or 340B program participation
• Experience interpreting and operationalizing complex contract language
• Paralegal experience or legal contract training
• Bachelor’s degree in Business, Healthcare Administration, Pharmacy Administration, or a related field
• Relevant certifications such as RPh or Certified Pharmacy Technician (CPhT)
• Proven ability to manage multiple priorities and deliver results in a fast-paced environment
   

Additional Expectations

• High level of integrity and discretion when handling sensitive contract and business information
• Strong communication and interpersonal skills with the ability to build relationships and influence stakeholders across all levels of the organization
• Ability to manage multiple priorities and deadlines while maintaining professionalism and accountability
• Willingness to travel up to 25% as needed
   

The expected salary range for this role is $100,000 to $175,000 per year, depending on experience, qualifications, and geographic location. In addition to base salary, this position is eligible for a 9% annual bonus opportunity and Omnicell's comprehensive benefits package.

• As Passionate Transformers, we find a better way to innovate relentlessly. 
• Being Mission Driven, we consistently deliver on our promises. 
• Our Entrepreneurial spirit makes the most of EVERY opportunity for innovation. 
• Understanding that Relationships Matter creates synergies that yield the greatest benefits for all.
• Intellectually Curious, eager to think deeper to learn and improve.
• In Doing the Right Thing, we lead by example in ALL we do. 

Omnicell is dedicated to fostering an inclusive workplace. We welcome applications from all individuals, valuing a wide range of perspectives and backgrounds. As an equal opportunity employer, we do not discriminate based on race, gender, religion, sexual orientation, gender identity, national origin, veteran status, or disability. We are committed to making our recruitment process accessible to everyone. We offer support and reasonable adjustments for individuals with disabilities during our hiring process. If you need assistance, please contact us at [email protected]. 

At Omnicell, respect for privacy and confidentiality is paramount. We adhere to strict policies to prevent discrimination or retaliation against those who engage in open conversations about compensation. However, employees privy to compensation information as part of their job role are expected to maintain confidentiality, except in specific circumstances outlined by law, such as during formal complaints, investigations, or as required by legal obligations.

Please note that Omnicell reserves the right to modify job roles and responsibilities as needed to meet our organization's evolving needs and drive our mission forward.