As a recognized Hemophilia Treatment Center and a Center of Excellence, the Washington Institute for Coagulation d/b/a Washington Center for Bleeding Disorders (WACBD), is committed to the wellbeing of patients with an inherited bleeding disorder across the State of Washington, neighboring states, and Alaska.

Our staff is an ensemble of dedicated healthcare professionals and support personnel that are striving to ease the burden that bleeding disorders have placed upon our patients.

Benefits include generous annual PTO, 401(k) match, 100% health insurance premiums paid for staff members, and on-site parking or transit pass at hire.

About the role

The Healthcare Contracts Manager plays a key role in advancing the organization’s mission by leading the negotiation, development, and management of payer contracts, collaborative agreements, and service partnerships with healthcare entities.

This position will collaborate with executive leadership, finance, and clinical teams to develop and maintain contracting strategies that drive organizational growth, optimize reimbursement for high-cost therapies, and secure favorable terms for new service lines or partnerships, operational effectiveness, and high‑quality care delivery across the organization’s programs.

Key Responsibilities

Payer Contract Management

• Proactively identify and pursue opportunities to establish and maintain payer contracts, network inclusions, and partnerships with commercial insurers, PBMs, medical coverage plans, self-insured employers, and local businesses to expand WACBD's in-network provider status and increase patient access/revenue streams.
• Lead negotiation, drafting, execution and maintenance of payer contracts
• Oversee proper entry of contract rates into organizational databases and ensure they are securely maintained.
• Analyze contract terms, reimbursement methodologies, and regulatory requirements to ensure alignment with organizational goals and compliance standards.
• Assure compliance with CMS, Payers, and Federal and State Laws impacting health care.
• Monitor changes in healthcare regulations, payer policies, and industry trends that may impact contract strategy and compliance.
• Proactively identify risks/opportunities and update the contracting process.
• Conduct market analysis of payer landscapes, emerging reimbursement models, and untapped opportunities in WA, MT, ID and beyond to inform proactive contracting initiatives and position WACBD for expanded network participation and revenue optimization.
• Serve as the primary point of contact for payer relations, maintaining strong working relationships, and addressing contract‑related issues.
• Act as a liaison between WACBD and WA State Healthcare Authorities (HCA).
• Secure and maintain WACBD’s Center of Excellence status and exclusivity.
• Attend public payer meetings and maintain current with State of Washington DSHS developments as well as any other state sponsored plans.
• Participate in Industry Trade Groups as appropriate.
• Stay up to date with the changes in the health care industry including all governmental agencies (i.e., HCFA), with regards to maximum reimbursement to the organization through the insurance process in a precise and detailed manner.
• Partner with the Medical Billing Manager to ensure all negotiated contract rates, fee schedules, and reimbursement terms are accurately loaded into the practice management system.
• Analyze payment variance reports in coordination with the billing team to identify underpayments, or systemic payer errors.
• Support revenue cycle team in interpreting contract terms (e.g., carve-outs for high-cost drugs, stop-loss thresholds, 340B modifiers) and resolving reimbursement issues.

340B Program Support

• As needed, aid the Pharmacy Director to review and negotiate contracts related to 340B pharmacy operations, including specialty pharmacy distribution, replenishment models, and third-party arrangements.
• Ensure contract language supports 340B compliance, program integrity, and audit readiness.
• Partner with pharmacy leadership to evaluate contract performance and optimize program savings.

Healthcare Contract Management

• Manage and update office of Pharmacy Affairs 340B Database.
• Develop and manage collaborative agreements, MOUs, and service contracts with hospitals, clinics, community partners, and other healthcare and community organizations.
• Work closely with the executive director, finance, compliance and legal teams to ensure that all contracts are thoroughly reviewed and aligned with internal policies and regulations
• Manage and support the WACBD, Pharmacy and Practitioner credentialing process in compliance with contractual terms.
• Collaborate with Pharmacy on Contract Pharmacy/Manufacturer applications, agreements and contracts, if applicable.

Audits, Reporting and Analysis

• Ensure all contracts adhere to federal and state regulations, including 340B, HIPAA, Medicaid/Medicare requirements, and Washington State healthcare laws.
• Conduct regular audits of contracts to ensure they are current and identify areas for improvement.
• Maintain documentation and audit trails to support compliance reviews and external audits.
• Track and report on new contract acquisition metrics, network expansion progress, and revenue impact from proactive contracting efforts to executive leadership, contributing to forecasting and strategic planning for organizational growth. Utilize data analytics to aid CFO to forecast revenue and identify potential risks and opportunities.

General

• Partner with clinical, pharmacy, finance, compliance/legal, and administrative teams to understand operational needs and translate them into effective contract structures.
• Provide contract interpretation, education, and guidance to internal stakeholders.
• Support strategic initiatives such as new service lines, partnerships, and program expansions.
• Partner with clinical, pharmacy, finance, compliance/legal, and administrative teams to evaluate contract performance and identify opportunities for improvement.
• Maintain accurate contract records, timelines, and renewal schedules.
• Provide outstanding customer service and educate partners on WACBD and 340B Pharmacy program demonstrating improved clinical outcomes and financial savings.
• Identify input and guidance related to CMS, State and Federal regulatory compliance requirements that impact new employee training and generate new policies and procedures.
• Manage proposals and contract development
• Attend collaborative meetings and organizational retreats.
• Other duties as assigned.

Qualifications

• Bachelor’s degree in a related field, or equivalent combination of education and experience
• 3–5+ years of experience in negotiating complex agreements with payers, PBMs, and healthcare vendors
• Strong understanding of Washington State healthcare regulations, reimbursement models, managed care structures, and healthcare regulatory requirements
• Thorough knowledge of Medicare, Medicaid and other governmental insurance regulations and CMS claims form
• Strong command of current coding standards (CPT, HCPCS, ICD-10) and their impact on reimbursement modeling
• Ability to interpret complex contract language and translate it into operational requirements
• Excellent negotiation, communication, and relationship building skills
• Strong organization skills
• Preference for experience in proactive payer outreach, network expansion, or business development in specialty/rare disease healthcare. Proven success building and closing complex PBM or payer contracts.
• Understanding of 340B program requirements and pharmacy contracting preferred
• Exceptional analytical skills, mathematical/accounting ability sufficient to support the management of the insurance billing and accounting systems
• Ability to maintain confidentiality per HIPAA requirements
• Experience with Microsoft office/365
• Experience with Hemophilia Treatment Centers (HTC) or high-cost specialty pharmacy contracting is a plus.