Contract Manager, Pharma

🔥 14 hours ago

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Logo of Option Care Health

Option Care Health

5001 - 10000 employees

Founded 1987

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare Insurance • Pharmaceuticals

Option Care Health is a leading national provider of infusion therapy services in the United States. The company offers treatment for a variety of acute and chronic conditions including neurological disorders, bleeding disorders, women's health issues, and heart failure. With over 170 nationwide infusion suite locations, Option Care Health collaborates with healthcare providers, pharmaceutical manufacturers, insurance providers, and health systems to deliver seamless and comprehensive care. Their services include IV antibiotics, nutrition support, immunoglobulin, and specialized therapies, with a strong commitment to patient care and quality outcomes. Option Care Health is in-network with all major health plans and is recognized for its high standards of care and patient support.

📋 Description

• 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. • 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.

🎯 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).

🏖️ 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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