Walgreens

Director, Payer Services

Walgreens$120K — $150K *
Healthcare
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in Healthcare, Business Administration, Finance, or a related field; or equivalent work experience
  • 10 years in the healthcare field or insurance industry, with managed care experience
  • 5 years of direct leadership and people management experience
  • Demonstrated understanding of pay-for-performance contracting methods
  • Strong analytical and strategic thinking skills to navigate complex operational environments
  • Experience leading cross-functional teams for successful business outcomes
  • Willingness to travel at least 40% for business purposes

Responsibilities

  • Develop and negotiate contracts to enhance financial performance and service quality
  • Ensure compliance with contracting goals, including pricing and revenue cycle support
  • Build positive relationships with payers for effective communication and collaboration
  • Collaborate with internal teams to establish top-line revenue strategies
  • Oversee the contracting process and manage payer interactions
  • Lead strategic product development for payer and PBM clients
  • Direct budget oversight and financial planning for the department

Benefits

  • Comprehensive healthcare coverage options
  • 401(k) retirement plan with company match
  • Professional development and training opportunities
  • Flexible working arrangements
  • Generous paid time off and holiday policies
Full Job Description
Job Description

Job Summary:
Responsible for the overall direction and management of Walgreens Specialty Pharmacy supportive payer product strategies and contracts. This position has primary leadership responsibility for the design, development, implementation and execution of systems, programs, and processes driving and supporting payer audit compliance, payer resolution, market insights, payer implementation, utilization management, performance guarantees, contracting, and pricing. The Director of Payer Services requires significant contact with marquee clients, internal senior leadership and sales executives, in addition to the management of employees on the team. This individual also requires the ability to problem solve innovative operational and product solutions and to construct and delegate/manage new project needs based on major enterprise initiatives undertaken

Job Responsibilities:
  • Develops and negotiate contracts that position the company to be successful, including improving financial performance, driving volume and creating contracts that incentivize improvement in the quality of the services the company offers
  • Ensures execution of contracting goals and objectives related to contract language and pricing, planning and execution, and revenue cycle support
  • Develops positive relationships with payers to facilitate a collaborative exchange of information and promote responsiveness to requests.
  • Leads the collaboration with internal stakeholders to build the top line revenue strategy, including finance, technology services, business development, operations, credentialing, etc. in order to meet the objectives negotiated in each payer contract
  • Develops and execute communication plans to internal stakeholders related to payer relationships, negotiations, and contractual obligations
  • Oversees the department to manage the contracting process including contract amendments, credentialing, payer complaints, database of account contacts and key account information
  • Ensures compliance with contracts, performance guarantees, legal requirements and company policies and procedures; stay abreast of all market relevant data including current healthcare trends, insurance products, competition, legislation, and pricing
  • Leads the collaboration internally and externally for strategic payer products
  • Leads the teams that oversees and coordinates all external payer audits of contract adherence (including desk audits, onsite audits
  • Oversees the pricing strategy for Walgreens Specialty Pharmacy.
  • Leads the collaboration and oversees the Implementation Team and performance guarantee process
  • Leads the patient, provider and client customer satisfaction across specialty and home delivery.
  • Supports RFPs and client finalist presentations.
  • Supervisory Responsibilities
  • Develops the strategy and the execution of market insights for the specialty division, including the management of internal teams and the relationship with all external contracted vendors.
  • Owns the specialty biosimilar strategy offering for payer and PBM clients, including developing unique products and services.
  • Responsible for the strategies related to optimizing channel performance and profitability amongst our central, community, and retail specialty pharmacy assets.
  • Responsible for the development, oversight and implementation of departmental budget
  • Responsible for leading a team through teaching, coaching and inspiring by fostering a sense of energy, ownership and a responsibility for the flawless execution of operational excellence engage in the selection and hiring process as needed.
  • Strong knowledge of pharmacy applications across both central and community-based specialty.
  • Other responsibilities as judgment or necessity dictate


External Basic Qualifications

  • Bachelor's degree in Healthcare, Business Administration, Finance, or related area of study; or equivalent combination of education and/or relevant work experience
  • 10 years' work experience in the healthcare field or insurance industry including direct managed care experience (either hospital or payer based), payer contracting, and contract negotiation experience
  • 5 years of direct and cross functional leadership/ people management experience
  • Demonstrated understanding pay for performance contracting methodologies
  • Strong healthcare experience; integrated healthcare (payer, provider and patient) preferred Demonstrated organizational skill with keen attention to detail and documentation
  • Experience in representing the company in industry and trade groups, key physician providers, government representatives and regulatory agencies, brokers, and the general public
  • Experience with strategy development and management in a matrix environment
  • Excellent verbal and written communication skills; strong analytical mind with the ability to think strategically in a complex operating environment; ability to problem solve quickly while working independently; strong negotiating and facilitation skills
  • Experience leading cross functional teams to meet business objectives with outstanding results
  • At least 2 years of experience contributing to financial decisions in the workplace.
  • At least 3 years of direct leadership, indirect leadership and/or cross-functional team leadership.
  • Willing to travel up to/at least 40% of the time for business purposes (within state and out of state).


Preferred Qualifications

  • Master's degree in business administration
  • BS in Pharmacy or Pharmacist Degree from an accredited educational institution

About Walgreens

Walgreens is the nation's largest drugstore chain with fiscal 2010 sales of $67 billion. The company operates 7,689 drugstores in all 50 states, the District of Columbia and Puerto Rico. Each day, Walgreens provides nearly 6 million customers the most convenient, multichannel access to consumer goods and services and trusted, cost-effective pharmacy, health and wellness services, and advice in communities across America. Walgreens scope of pharmacy services includes retail, specialty, infusion, medical facility, and mail service, along with respiratory services. These services improve health outcomes and lower costs for payers including employers, managed care organizations, health systems, pharmacy benefit managers, and the public sector. Take Care Health Systems is a Walgreens subsidiary that is the largest and most comprehensive manager of worksite health centers and in-store convenient care clinics, with more than 700 locations throughout the country.

Walgreens Careers

Joining Walgreens means becoming part of a team dedicated to inspiring health and well-being across America. As a cornerstone of the community, Walgreens offers unparalleled job opportunities in the retail and healthcare sectors, making it an ideal place for professional growth and innovation. Work You’ll Do At Walgreens, every position contributes to our mission of delivering premier health solutions while ensuring a diverse and inclusive workplace that fosters growth. Our team members are at the forefront of transforming customer experiences through dedication and expertise. Lead with Innovation and Leadership Embrace the opportunity to lead at Walgreens, where we combine industry expertise with a culture of innovation. Our leadership is committed to nurturing a professional environment where ideas thrive and leadership skills are honed through comprehensive diversity training and leadership development programs. Engage in Meaningful Work Join a team that values hard work and creativity, where your skills will be enhanced through challenging projects and collaborative team efforts. Walgreens is not just about filling prescriptions—it's about offering solutions that promote healthier communities. Explore Career Opportunities Whether you're looking for an entry-level position or a more advanced professional role, Walgreens offers a range of career paths in dynamic business areas. From in-store roles to corporate support, our job opportunities are designed to fit a variety of skills and interests. Internship and Employment Benefits Start your career with a Walgreens internship and gain hands-on experience that paves the way for future employment. Our interns work on real projects that matter, gaining skills that are crucial for future success. Full-time team members enjoy a wealth of benefits, including comprehensive health coverage, retirement plans, and exclusive employee discounts. Invest in Your Career Growth Walgreens is committed to the career development of our employees. We provide resources and training that encourage continuous learning and career advancement. With support for certifications and networking opportunities, team members can expand their professional horizons and achieve their career goals. Stay Connected Join Our Team Discover the diverse range of hiring opportunities at Walgreens by exploring open positions that match your skills and interests. We are looking for passionate, curious, and solution-driven team players ready to make a significant impact. Keep Up to Date Stay informed with career tips, insider perspectives, and industry-leading insights you can put to use today—all from the people who work at Walgreens. Job Alert Emails Customize your subscription to receive job alerts, the latest news, and insider tips tailored to your preferences. Explore the exciting and rewarding opportunities that await at Walgreens. At Walgreens, we are excited to see where your ambition takes you. Join us and be part of a team that is dedicated to shaping the future of health and wellness for everyone.
Learn more about Walgreens
Size
202,000 employees
Market Cap
$32.8 billion
Industry
Net Income
-$696 million
Founded
1901
5 Year Trend
+2.3%
Revenue
$141.5 billion
NASDAQ

Similar Jobs

More Jobs at Walgreens

  • Walgreens
    Store Manager
    $50K — $120K *
    Chicago, IL 60629 (Cook County)
    Retail & Consumer Goods
    In-Person
  • Walgreens
    Pharmacy Manager
    $110K — $130K *
    Wilmington, DE 19805 (New Castle County)
    Healthcare
    In-Person
  • Walgreens
    Pharmacy Manager
    $110K — $130K *
    New Braunfels, TX 78130 (Comal County)
    Healthcare
    In-Person
  • Walgreens
    Store Manager
    $50K — $120K *
    Albany, OR 97322 (Linn County)
    Retail & Consumer Goods
    In-Person
  • Walgreens
    Pharmacy Manager
    $100K — $120K *
    Kewanee, IL 61443 (Henry County)
    Pharmaceuticals & Biotech
    In-Person

More Healthcare Jobs

Find similar Director, Payer Services jobs: