Payer Contracting Manager, Home Infusion

The Cigna Group

Payer Contracting Manager collaborating with health systems on home infusion pharmacy contracts. Optimizing payer strategies and ensuring alignment with operational outcomes at Evernorth.

Posted 7/2/2026full-timeRemote • 🇺🇸 United StatesSeniorLead💰 $103,900 - $173,100 per yearWebsite

About the role

Key responsibilities & impact

Partner with CarePathRx’s health system partners on optimizing contracts for their home infusion pharmacy including: Developing payor priorities for securing contracts
Reviewing payor contracts and related amendments and providing related recommendations
Evaluating and analyzing proposed rates against benchmarks, including per diem and drug rates
Partner guidance during health system implementation of their home infusion pharmacy for the health system partner and CarePathRx including: Aligning all processes to the overall implementation timelines, including payor credentialing application process
Providing consultation, education and training on contract requirements to Intake and Billing/Collection teams, including information regarding payor reimbursement methodologies, rates and policies
Working cross-functionally to ensure contract or amended rates and payor information is loaded accurately by the appropriate team for system optimization
Ensure ongoing success of the home infusion pharmacy contract strategy through: Maintaining the knowledgebase particular to benchmark rates and managed care terms; leverage this data to inform health system partner strategies
Managing payor contracts and amending reference materials to support all teams
Liaison with internal and external teams when needed for resolution of payer processing issues around payer contract load issues
Set the strategic direction for payer contract management, ensuring contracts are operationalized effectively to support accurate benefit verification, billing, and collections
Oversee payer change management strategy, including prioritization, risk mitigation, and cross‑functional coordination for payer updates across the client base.
Provide executive oversight for payer audits, ensuring timely, compliant, and effective responses while identifying systemic improvement opportunities.
Define cadences for review of contracting pricing and support on best practices to move forward optimizing outcomes and results
Serve as a trusted advisor to client executives and internal leadership, translating payer performance into strategic insights and recommendations
Foster strong cross‑functional relationships to align operations and partner managed care teams for payer engagement strategies.

Requirements

What you’ll need

High School Diploma or GED required
Bachelor’s degree in finance, Accounting, Business Administration, or related field highly desired
Demonstrated 8+ years of payer or contract management experience in specialty pharmacy and/or infusion therapy required
Advanced knowledge of health insurance plans: Managed Care Organizations, PPO, POS, Self-Funded, TPAs and providers at financial risk (hospital/health systems, medical group/IPA)
Strong understanding of healthcare billing, reimbursement, regulatory requirements, and financial controls
Strategic, analytical mindset with the ability to balance long‑term vision and operational outcomes
Expertise in building strong relationships with regional and national payors and health system clients in the managed care and leadership arena
Operational knowledge to translate contractual language into successful implementation with teams
Ability to manage multiple priorities
Ability to work independently and execute deadlines effectively
Proficiency in Microsoft Excel, Microsoft Word, and PowerPoint
Experience with CPR +, CareTend, HCN EMR systems preferred.

Benefits

Comp & perks

Health insurance
Vision insurance
Dental insurance
Well-being and behavioral health programs
401(k)
Company paid life insurance
Tuition reimbursement
Minimum of 18 days of paid time off per year
Paid holidays
Leaves of absence

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Contract ManagementPayer Reimbursement MethodologiesFinancial ControlsOperational ImplementationAnalytical Skills

Soft Skills

Strong CommunicationIndependent ExecutionCross-Functional CollaborationStrategic ThinkingTime Management