Specialist Payer Relations

Overview

Versiti is a fusion of donors, scientific curiosity, and precision medicine that recognize the gifts of blood and life are precious. We are home to the world-renowned Blood Research Institute, we enable life saving gifts from our donors, and provide the science behind the medicine through our diagnostic laboratories. Versiti brings together outstanding minds with unparalleled experience in transfusion medicine, transplantation, stem cells and cellular therapies, oncology and genomics, diagnostic lab services, and medical and scientific expertise. This combination of skill and knowledge results in improved patient outcomes, higher quality services and reduced cost of care for hospitals, blood centers, hospital systems, research and educational institutions, and other health care providers. At Versiti, we are passionate about improving the lives of patients and helping our healthcare partners thrive.

Position Summary

The Payer Relations Specialist serves as the subject matter expert for payer engagement and managed care strategy. This role is responsible for developing and maintaining relationships with commercial health plans, pharmacy benefit managers (PBMs), government payers, and employer stakeholders to gain network participation and optimize reimbursement for Versiti's Comprehensive Center for Bleeding Disorders (CCBD) Hemophilia Treatment Center (HTC) and 340B Specialty Pharmacy. The Payer Relations Specialist collaborates with HTCs, institutional contracting teams, advocacy organizations, and internal departments to advance payer access, support specialty therapy distribution strategies, and promote CCBD as a Center of Excellence for bleeding disorder care.

Total Rewards Package

CompensationThe target salary is based on internal averages. Versiti sets salary ranges aligned to local markets in which the job is performed. Compensation decisions take into account internal salary averages and differentiation based on education, experience, skills, and performance. Specific salary and benefits information is shared at the time of the phone screening based on your location and qualifications.BenefitsVersiti provides a comprehensive benefits package based on your job classification. Full-time regular employes are eligible for Medical, Dental, and Vision Plans, Paid Time Off (PTO) and Holidays, Short- and Long-term disability, life insurance, 7% match dollar for dollar 401(k), voluntary programs, discount programs, others.

Responsibilities

• Develop and maintain relationships with commercial insurers, PBMs, government payers, and employer groups; negotiate participation agreements and ensure network access. Monitor coverage policies, reimbursement, and market trends.
• Work with the CCBD and Pharmacy teams to support payer contracting, reimbursement strategies, and network participation. Provide guidance and education to strengthen payer engagement.
• Collaborate on wholesale drug distribution agreements and specialty therapy access strategies.
• Participate in the development and implementation of payer relations strategies. Engage with patient advocacy organizations and employer groups to promote CCBD as a Center of Excellence.
• Ensure all payer contracting, PBM participation, and specialty therapy distribution activities comply with federal, state, and payer regulations. Support CCBD/Pharmacy in meeting accreditation requirements and maintain documentation for audits or regulatory review.
• Attend industry conferences, payer meetings, and trade associations. Track policy changes and share insights to strengthen effectiveness with payers.
• Maintain documentation, review contracting data, support internal reporting, and track contract performance metrics.
• Performs other duties as required or assigned which are reasonably within the scope of the duties in this job classification
• Understands and performs in accordance with all applicable regulatory and compliance requirements
• Complies with all standard operating policies and procedures

Qualifications

Education

• Bachelor's Degree in Business Administration, Healthcare Administration, or related field required

Experience

• At least 5+ years of progressive experience in healthcare payer relations, managed care, or provider network contracting required
• Less than 1 year experience with Hemophilia Treatment Centers (HTCs), specialty pharmacies, or rare disease provider networks preferred

Knowledge, Skills and Abilities

• Knowledge of managed care, PBMs, and payer contracting processes, including specialty therapy reimbursement and network participation. required
• Understanding of medical and pharmacy benefit structures, including buy-and-bill and specialty pharmacy distribution models. required
• Ability to develop and maintain strategic relationships with payers, PBMs, advocacy organizations, and institutional partners. required
• Strong analytical, negotiation, and problem-solving skills for evaluating contracts, reimbursement trends, and policy changes. preferred
• Excellent verbal and written communication skills preferred
• Ability to exercise independent judgment and discretion in payer strategy and contracting initiatives. preferred
• Knowledge of regulatory compliance and specialty pharmacy accreditation standards. preferred
• Ability to manage multiple projects, prioritize tasks, and travel nationally as required. required

Tools and Technology

• Microsoft Suite (Word, Excel, PowerPoint, Outlook) required
• Personal Computer (desk top, lap top, tablet) required
• General office equipment (computer, printer, fax, copy machine) required

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