CarepathRx
Healthcare Insurance • Pharmaceuticals • SaaS
CarepathRx is a comprehensive pharmacy care provider, partnering with health systems, hospitals, physicians, and pharmacies. The company offers a variety of solutions, including home and ambulatory infusion services, specialty pharmacy, and telepharmacy technology. CarepathRx aims to expand the continuum of infusion services to various settings such as the home, physician offices, and outpatient clinics to enhance patient experiences and retain patient services within their network. They also focus on leveraging remote pharmacy resources to provide cost-effective services like medication reconciliation and patient counseling. Through their expertise, operational scale, and technology capabilities, CarepathRx supports unique pharmacy strategies for their partners.
Manager, Payor Relations
Job not on LinkedIn
October 24
CarepathRx
Healthcare Insurance • Pharmaceuticals • SaaS
CarepathRx is a comprehensive pharmacy care provider, partnering with health systems, hospitals, physicians, and pharmacies. The company offers a variety of solutions, including home and ambulatory infusion services, specialty pharmacy, and telepharmacy technology. CarepathRx aims to expand the continuum of infusion services to various settings such as the home, physician offices, and outpatient clinics to enhance patient experiences and retain patient services within their network. They also focus on leveraging remote pharmacy resources to provide cost-effective services like medication reconciliation and patient counseling. Through their expertise, operational scale, and technology capabilities, CarepathRx supports unique pharmacy strategies for their partners.
📋 Description
• Establish and maintain payor relationships before and after contracting; this includes managing payor contracts and required reporting. • Lead payor contract negotiations for new and renewal contracts, ensuring favorable terms and competitive reimbursement rates. • Work collaboratively with operations, billing, clinical, and marketing teams to ensure alignment of payor strategies with the overall business objectives. • Ensure that payor agreements comply with state and federal regulations, industry standards, and accreditation. • Provide leadership, guidance, and manage direct reports. • Oversee credentialing processes to ensure timely and accurate provider enrollment. • Assist management team and participates in other duties to meet company objectives as directed by leadership.
🎯 Requirements
• Bachelor’s degree in Healthcare Management, Business Administration, or a related field (or equivalent experience). • Minimum of 5 years of experience in payor relations, payor contract management, or related functions within specialty pharmacy, infusion therapy, or healthcare services. • Proven experience negotiating and managing complex payor contracts with regional and national health plans or PBMs. • Strong communication and relationship-building skills across internal and external stakeholders.
🏖️ Benefits
• Medical, Dental and Vision Benefits for you and your family • 401(k) with Company Match • Company-paid Life Insurance and Disability Benefits • Paid Company Holidays • Paid Time Off and Volunteer Time Off • Flexible spending
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