Reimbursement Contract Manager

Soleo Health•Frisco, TX

7d•$68 - $86•Remote

About The Position

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.

Requirements

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

Responsibilities

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