Position Summary

The Specialist, Contract Operations is responsible for the precise operational entry, and lifecycle maintenance of payer contract data, pricing methodologies, and reimbursement structures within specialty pharmacy systems.

This role functions as the operational processing layer within the contract-to-claim lifecycle, ensuring that structured contract requirements are accurately translated into system configurations and consistently maintained to support downstream validation, claims processing, and financial realization. The Specialist plays a critical role in preserving data integrity by managing pricing updates, payer configurations, and contract documentation with a high degree of accuracy, control, and traceability.

Operating in close partnership with Quality Assurance & Validation, this role ensures that all contract-related data and system updates are complete, aligned, and audit-ready prior to validation and claim generation. By strengthening the accuracy and consistency of upstream inputs, the Specialist directly contributes to reducing operational rework, minimizing reimbursement risk, and supporting scalable, controlled contract operational processing across all payer types.

Essential Functions and Duties

Contract Data Execution & System Integrity

• Translate structured business and contract requirements into precise system inputs, ensuring alignment with executed payer agreements
• Maintain payer mappings, contract attributes, and configuration elements required to support accurate claims adjudication
• Apply strong attention to system logic and dependencies to ensure consistency, completeness, and integrity of all data inputs

Pricing Operations & Maintenance

• Execute and maintain recurring pricing updates (monthly, quarterly, ad hoc) across methodologies including AWP, ASP, WAC, NADAC, and payer-specific fee schedules
• Retrieve, validate, and apply pricing data from external sources (e.g., Redbook, RJ Health, Medicaid, Medicare)
• Coordinate and implement pricing updates across all impacted systems, ensuring full population and alignment across datasets
• Proactively identify gaps, inconsistencies, or anomalies in pricing data and escalate for resolution

Contract Implementation Support

• Support operationalization of executed payer agreements by aligning contract terms with system configuration requirements
• Partner with Managed Markets, Reimbursement, and Operations to ensure accurate interpretation and execution of contract constructs as data points
• Assist in onboarding new payer contracts and maintaining updates to existing agreements across systems
• Develop working knowledge of reimbursement methodologies and payer-specific requirements to strengthen execution accuracy

Documentation, Traceability & Audit Readiness

• Maintain comprehensive, structured, and audit-ready documentation of all contract data, pricing updates, and system configuration changes
• Ensure all updates are fully traceable to source contract language and appropriately version-controlled
• Support internal controls by maintaining organized records that align with audit, compliance, and governance standards
• Contribute to the development and maintenance of standard operating procedures and documentation frameworks

Pre-Validation Data Quality Support

• Perform structured completeness and accuracy checks on all data inputs prior to Quality Assurance validation
• Identify discrepancies, incomplete data, or potential errors and escalate for correction before downstream impact
• Prepare datasets, supporting documentation, and system outputs for QA review and validation processes
• Reinforce upstream data quality to reduce downstream rework, claim adjustments, and operational inefficiencies

Cross-Functional Execution & Coordination

• Collaborate with Managed Markets, Reimbursement, Intake, Authorizations, Operations, and IT to support coordinated contract implementation
• Align execution timelines with operational dependencies and system readiness requirements
• Track assigned work, monitor progress, and ensure timely and accurate completion of deliverables
• Support clear communication and coordination across teams to ensure consistency in execution

Process Discipline & Continuous Improvement

• Execute responsibilities in alignment with established workflows, governance standards, and control frameworks
• Identify opportunities to improve efficiency, reduce manual intervention, and strengthen data accuracy
• Support automation, system integration, and process improvement initiatives in partnership with IT and Operations
• Contribute to the development of scalable, repeatable operational processes that support long-term growth

General Responsibilities

• Adheres specifically to all company policies and procedures, Federal and State regulations, and laws.
• Display dedication to position responsibilities and achieve assigned goals and objectives.
• Always represent the Company in a professional manner and appearance.
• Understand and internalize the Company’s purpose.
• Display loyalty to the Company and its organizational values.
• Display enthusiasm and dedication to learning how to be more effective on the job and share knowledge with others.
• Work effectively with co-workers, internal and external customers and others by sharing ideas in a constructive and positive manner; listen to and objectively consider ideas and suggestions from others; keep commitments; keep others informed of work progress, timetables, and issues; address problems and issues constructively to find mutually acceptable and practical business solutions; address others by name, title, or other respectful identifier, and respect the diversity of our work force in actions, words, and deeds.
• Comply with the policies and procedures stated in the Injury and Illness Prevention Program by always working in a safe manner and immediately reporting any injury, safety hazard, or program violation.
• Ensure conduct is consistent with all Compliance Program Policies and procedures when engaging in any activity on behalf of the company. Immediately report any concerns or violations.
• Other duties as assigned.

Education, Knowledge, Skills, and Experience

Required Education:

• Associate’s or Bachelor’s degree in Business, Healthcare Administration, Finance, or a closely related field.
• In lieu of a degree, equivalent professional knowledge and experience may be considered.

Preferred Education:

• Bachelor’s degree in a related field.

Required Knowledge:

• Foundational understanding of structured data management, system workflows, and data entry accuracy principles
• Basic understanding of documentation standards, traceability, and recordkeeping practices
• Working knowledge of Microsoft Excel and data organization techniques

Preferred Knowledge:

• Knowledge of healthcare reimbursement processes, electronic claims processing, or specialty pharmacy operations
• Familiarity with payer structures, managed care environments, and contract pricing methodologies (AWP, ASP, WAC, NADAC)
• Exposure to benefit verification, prior authorizations, and payer eligibility requirements

Required Experience:

• Minimum two (2) to four (4) years of experience in data entry, operational support, or system-based administrative roles
• Experience working with structured datasets, spreadsheets, or system configuration inputs
• Experience supporting cross-functional teams in a deadline-driven environment

Preferred Experience:

• Experience in healthcare, specialty pharmacy, reimbursement operations, or managed care environments
• Exposure to contract administration, pricing updates, or system configuration support
• Experience working in audit, compliance, or control-focused environments

Required Skills:

• Exceptional attention to detail and commitment to data accuracy
• Strong organizational and task management capabilities
• Ability to follow structured processes and execute with consistency and discipline
• Strong written and verbal communication skills
• Ability to work independently while collaborating across teams
• Proficiency in Microsoft Office, particularly Excel
• Ability to prioritize and manage multiple concurrent tasks effectively

Preferred Skills:

• Experience with healthcare systems or ERP platforms
• Exposure to QA, validation, or audit support processes
• Experience supporting process improvement or automation initiatives

Physical requirements

Vision, hearing, speech, movements requiring the use of wrists, hands and/or fingers. Must have the ability to view a computer screen for prolonged periods and the ability to sit for extended periods. Must have the ability to work the hours and days required to complete the essential functions of the position, as scheduled. Must have the ability to lift and maneuver items of at least 20 lbs. Must have the ability to travel occasionally. Working condition include normal office setting.

Mental Demands

Learning, thinking, concentration and the ability to work under pressure, particularly during busy times. Must be able to pay close attention to detail and be able to work as a member of a team to ensure excellent customer service. Must have the ability to interact effectively with co-workers and customers, and exercise self-control and diplomacy in customer and employee relations’ situations. Must have the ability to exercise discretion as well as appropriate judgments when necessary. Must be proactive in finding solutions.

Direct Reports

No

EEO Statement

FFF Enterprises and Nufactor are an equal opportunity employer and prohibits discrimination and harassment based on the following characteristics: race, color, religion, national origin, physical or mental disability, gender, age (40 years and over) qualified veteran and any other characteristic protected by state or federal anti-discrimination law covering employment. These categories are defined according to Government Code section 12920. The Company prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has or is perceived as having any of those characteristics.

Acknowledgement

The above statements are intended to describe the general nature and level of work being performed by the incumbent assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and/or skills required of all personnel so classified.

The undersigned employee acknowledges receipt of the Job Description for the employee’s position and understands the essential functions, responsibilities, and qualifications of the position. Furthermore, the employee acknowledges that this Job Description does not include all the essential functions of this position, and that these essential functions may change as deemed necessary by the manager.