Contract Manager - Pharma

Option Care HealthBannockburn, IL
20h$78,973 - $131,615

About The Position

Extraordinary Careers. Endless Possibilities. With the nation’s largest home infusion provider, there is no limit to the growth of your career. Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team members including 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and team members. Join a company that is taking action to develop an inclusive, respectful, engaging and rewarding culture for all team members. At Option Care Health your voice is heard, your work is valued, and you’re empowered to grow. Cultivating a team with a variety of talents, backgrounds and perspectives makes us stronger, innovative, and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a culture that attracts, hires and retains the best and brightest talent in healthcare. Job Description Summary: Manage the negotiation, preparation, financial analysis, business review, and implementation of assigned pharmaceutical contracts for Option Care. Resolve reimbursement issues arising from contract compliance issues. Manage performance reporting to clients. Handle day to day issues that may arise out of existing contractual relationships with accounts. Job Description: Manage the negotiation of pharmaceutical supply chain, distribution, and service contracts in accordance with company guidelines for assigned geography for home and alternate site infusion therapy services provided by Option Care. Manage internal implementations of assigned agreements with corporate stakeholders, as well as regional intake, operations, and revenue cycle teams in order to ensure success of contract implementation and execution. Manage external implementations and foster ongoing relationships with assigned accounts. Manage communication with assigned accounts as it relates to demographic changes to Option Care Facilities to insure trade partner agreements are current in order to facilitate national continuity. Initiate and lead meetings with health plans and corporate teams, including Pharmaceutical Program Services and Operational leadership, to review provider agreement performance data and scorecards. . Recommends course of action to reduce/minimize risk to the organization. Identifies, and assesses impact of potential changes in the industry or changes related to new state or federal legislation. Resolve pricing and service fee related issues identified by internal and/or external trader partners that may be related to contract compliance. Attends client meetings where appropriate and in collaboration with Pharmaceutical Program, Business Development or other representative. Maintains successful working relationships with internal departments such as Operations, Legal, Sales, Trade and Business Development and any other departments that are involved with or impacted by managed care contracts. Utilize and participate in deployment of new contract management system. Complete credentialing applications when necessary for new contract access. Initiate, organize and facilitate regular touchpoints with Legal counterpart to ensure timely review and execution of contracts within the DocuSign and Salesforce environments. Initiate monthly meetings with assigned Contracting Mentor(s) for development opportunities. Participate in regional meetings as directed by VP, Contracting.

Requirements

  • High school diploma and 5 yrs of experience in managed care account management, contract analysis or administration, or with managed care payers through patient registration or revenue cycle in the health care industry.
  • Experience in working with managed care clients and familiarity with contract terms and conditions in the ancillary arena.
  • Experience with analyzing and reporting data in order to identify issues, trends, or exceptions to drive improvement of results and find solutions.
  • Experience providing customer service to internal and external customers, including meeting quality standards for services.
  • Experience with Home Infusion or Specialty pharmacy
  • Experience with CPR+ preferred
  • Experience using time management skills such as prioritizing/organizing and tracking details and meeting deadlines of multiple projects with varying completion dates.
  • Intermediate level skill in Microsoft Excel (for example: using SUM function, setting borders, setting column width, inserting charts, using text wrap, sorting, setting headers and footers and/or print scaling).
  • Intermediate level skill in Microsoft PowerPoint (for example: applying a theme, formatting character spacing, inserting a picture, changing slide layout and theme colors, adding transitions, customizing slide numbers, changing chart style and/or formatting font).
  • Intermediate level skill in Microsoft Word (for example: inserting headers, page breaks, page numbers and tables and/or adjusting table columns).
  • Willing to travel up to 25% of the time for business purposes (within state and out of state).

Nice To Haves

  • Bachelor's degree and 3-5yrs of experience in managed care contract management within the health care industry.

Responsibilities

  • Manage the negotiation of pharmaceutical supply chain, distribution, and service contracts in accordance with company guidelines for assigned geography for home and alternate site infusion therapy services provided by Option Care.
  • Manage internal implementations of assigned agreements with corporate stakeholders, as well as regional intake, operations, and revenue cycle teams in order to ensure success of contract implementation and execution.
  • Manage external implementations and foster ongoing relationships with assigned accounts.
  • Manage communication with assigned accounts as it relates to demographic changes to Option Care Facilities to insure trade partner agreements are current in order to facilitate national continuity.
  • Initiate and lead meetings with health plans and corporate teams, including Pharmaceutical Program Services and Operational leadership, to review provider agreement performance data and scorecards.
  • Recommends course of action to reduce/minimize risk to the organization.
  • Identifies, and assesses impact of potential changes in the industry or changes related to new state or federal legislation.
  • Resolve pricing and service fee related issues identified by internal and/or external trader partners that may be related to contract compliance.
  • Attends client meetings where appropriate and in collaboration with Pharmaceutical Program, Business Development or other representative.
  • Maintains successful working relationships with internal departments such as Operations, Legal, Sales, Trade and Business Development and any other departments that are involved with or impacted by managed care contracts.
  • Utilize and participate in deployment of new contract management system.
  • Complete credentialing applications when necessary for new contract access.
  • Initiate, organize and facilitate regular touchpoints with Legal counterpart to ensure timely review and execution of contracts within the DocuSign and Salesforce environments.
  • Initiate monthly meetings with assigned Contracting Mentor(s) for development opportunities.
  • Participate in regional meetings as directed by VP, Contracting.

Benefits

  • Medical, Dental, & Vision Insurance
  • Paid Time off
  • Bonding Time Off
  • 401K Retirement Savings Plan with Company Match
  • HSA Company Match
  • Flexible Spending Accounts
  • Tuition Reimbursement
  • myFlexPay
  • Family Support
  • Mental Health Services
  • Company Paid Life Insurance
  • Award/Recognition Programs
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