Bachelor's degree in business, healthcare administration, or related field, or 7+ years of leadership experience in healthcare or managed care., Proven negotiation skills and experience managing complex payer agreements., Deep knowledge of healthcare reimbursement models, credentialing standards, and regulatory requirements., Experience in revenue recovery, claims resolution, and payer compliance..
Key responsibilities:
Lead payer contracting strategy and negotiations for targeted drug delivery services.
Collaborate with revenue cycle management to enforce contract terms and support revenue recovery.
Maintain relationships with payers to resolve issues and influence reimbursement policies.
Oversee contract lifecycle management, including performance tracking and renewal strategies.
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As the leading provider of targeted drug delivery (TDD) and infusion care, AIS Healthcare is committed to doing more of what matters. From pharmacies that put patient safety first to comprehensive services that enhance the entire care experience, we go beyond the expected across our two divisions.
● A center of excellence in high-risk intrathecal compounding, AIS Healthcare Targeted Drug Delivery prepares and ships more than 140,000 patient-specific dispenses annually to all 50 states. We also offer comprehensive care services to support patients and empower providers, including in-home pump care and care coordination services.
● At Advanced Infusion Care, we provide high-quality intravenous (IV) and subcutaneous (SubQ) immunoglobulin therapies and in-home care to more than 1,500 patients across the country. Our nationally accredited home infusion team, including infusion nurse specialists and clinical pharmacists, partner closely with physicians to provide the best possible infusion care.
AIS Healthcare is dually accredited by URAC and the Accreditation Commission for Health Care (ACHC).
Director of Contracting - Targeted Drug Delivery (TDD)
This is a 100% remote opportunity
AIS Healthcare is the leading provider of Targeted Drug Delivery (TDD) and Infusion Care With our diverse culture, and our values around Innovation, Stewardship, and Unity, we are committed to Advancing Quality, and Improving Lives. We are dedicated to doing more for our patients by providing quality products and services that enhance the entire care experience.
The Director of Contracting - Targeted Drug Delivery (TDD) leads payer contracting strategy, negotiation, execution, and performance specific to targeted drug delivery services. This role is responsible for alignment of reimbursement methodologies with financial sustainability, while also driving revenue recovery efforts, and payer compliance. The Director of Contracting - Targeted Drug Delivery (TDD) works cross-functionally with executive leadership, clinical teams, revenue cycle, and legal to expand access and optimize payer performance.
AIS Healthcare offers great benefits, including health, vision and dental insurance, long term disability insurance, life insurance, a vacation package, 401K plan with a generous employer match, work from home opportunity, growth, and more! Additionally, we offer a 100% work from home model.
Education And Experience
Bachelor’s degree in business, healthcare administration, or related field required OR
7+ years of progressive leadership experience in managed care, payer contracting, or healthcare administration.
Proven experience negotiating and managing complex payer agreements.
Deep knowledge of healthcare reimbursement models, credentialing standards, and regulatory requirements.
Experience in revenue recovery, underpayment identification, claims resolution, and payer compliance.
Preferred Experience
In-depth knowledge of targeted drug delivery reimbursement methodologies, payer coverage policies, and regulatory requirements.
Key Responsibilities
Lead payer contracting and credentialing strategy for targeted drug delivery therapies, aligning contract terms with AIS clinical, operational, and financial objectives.
Collaborate with revenue cycle management to enforce contract terms, escalate unresolved payer issues, and support recovery efforts by resolving underpayments, denials, and reimbursement discrepancies.
Maintain strong relationships with payer counterparts to resolve issues, advocate for network inclusion, influence reimbursement policy updates, and renegotiate terms.
Serve as a key escalation point, overseeing the TDD Single Case Agreement (SCA) and Letter of Authorization (LOA) processes to ensure timely execution, reimbursement integrity, and financial viability, while enhancing payer collaboration, revenue optimization and patient access.
Develop and operationalize customized payment models that align with each payer’s network criteria, including AWP-based, flat rate, or value-based arrangements, ensuring reimbursement methodologies support both payer standards and service profitability while maintaining patient access.
Oversee contract lifecycle management, including execution, performance tracking, compliance, and renewal strategies with a focus on identifying payer-specific trends and financial risks.
Support payer network credentialing and participation efforts for TDD services across all markets.
Deliver detailed reporting to executive leadership on contract performance, payer trends, revenue recovery outcomes, and strategic opportunities.
Lead cross-functional projects aimed at improving payer alignment, expanding network access, and supporting TDD service growth.
Perform additional duties as assigned by leadership to support department goals and business priorities.
Required profile
Experience
Level of experience:Senior (5-10 years)
Industry :
Pharmaceuticals
Spoken language(s):
English
Check out the description to know which languages are mandatory.