Specialist, Operations

Posted Wednesday, April 29, 2026 at 10:00 AM | Expires Wednesday, July 1, 2026 at 9:59 AM

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.

• Carry out accurate entry, configuration, and maintenance of payer contracts, reimbursement rules, and pricing structures within Nufactor’s system of record
• 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

• 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 elevate for resolution

• 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

• 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

• Perform structured completeness and accuracy checks on all data inputs prior to Quality Assurance validation
• Identify discrepancies, incomplete data, or potential errors and elevate 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

• 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

• 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

• Adheres specifically to all company policies and procedures, Federal and State regulations, and laws
• Display dedication to…