Reimbursement Contract Manager

Job Description

Job Description

Description:

Soleo Health is seeking a Reimbursement Contract Manager to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care!

Significant specialty pharmacy or home infusion experience required.

Soleo Health Perks:

• Competitive Wages
• 401(k) with a Match
• Referral Bonus
• Paid Time Off
• Great Company Culture
• Annual Merit Based Increases
• No Weekends or Holidays
• Paid Parental Leave Options
• Affordable Medical, Dental, & Vision Insurance Plans
• Company Paid Disability & Basic Life Insurance
• HSA & FSA (including dependent care) Options
• Education Assistance Program

The Position:

The Reimbursement Contracts Manager is responsible for supporting the intake and reimbursement teams in the area of commercial contracting and government programs. This position involves research of payor contracts and other published information, publication and maintenance of resource documents and communication with provider relation teams to resolve contract and/or regulation non-compliance. Responsibilities include:

• Review payor contracts for intake and reimbursement contract terms (e.g., timely filing, clean claim payment terms) and for comprehensive fee provisions/fee schedules common billable services (e.g., per diems, nursing and drugs)
• Work with Managed Markets team to address any missing or unfavorable intake and reimbursement contract terms
• Provide comprehensive analyses of missing or unfavorable intake and reimbursement contract terms to VP of Reimbursement and CFO or their respective designees
• Provide payor education to intake and reimbursement teams, including reimbursement trends and policies
• Create, maintain, and manage all Intake and Reimbursement contract resource documents. Cultivate and maintain effective working relationship with contracted and non-contracted insurance Provider Relations personnel
• Work with Provider Relations personnel to address intake and reimbursement trending issues (e.g., claim denials, non-compliance with contract terms)
• Identify opportunities for cost savings and cash collections through payer reimbursement analysis/trends
• Be a contributor to internal and external departmental conversations regarding payers, contracts and industry knowledge
• Completes all necessary managerial tasks for direct reports including hiring, training, addressing performance issues, developing team goals and objectives, performance reviews, conflict resolution, and strategic planning
• Other duties as assigned by manager

Schedule:

• 8:30a-5pm typical business hours with overtime as needed

• Bachelor's Degree or a minimum of 5 years of Reimbursement/Account Management experience with injectable or infused drugs, or medical device products that require reimbursement support. High school diploma (or equivalent) required
• Significant specialty pharmacy or home infusion experience required
• Demonstrated proficiency in working on Medicare, Medicaid, or Managed Care reimbursement issues at the provider and payer levels
• Possess exceptional verbal and written communication skills, along with problem solving and organizational skills
• Strong business, analytical, administrative, and team building skills are essential

About Us: Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference!

Soleo’s Core Values:

• Improve patients’ lives every day
• Be passionate in everything you do
• Encourage unlimited ideas and creative thinking
• Make decisions as if you own the company
• Do the right thing
• Have fun!

Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture.

Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.

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