Reimbursement Contract Manager

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🕒 April 10

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Soleo Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

💊 Pharmaceuticals

🧘 Wellness

Healthcare Insurance • Pharmaceuticals • Wellness

Soleo Health is a specialty pharmacy company that goes beyond simply filling prescriptions by providing personalized patient experiences and access to specialized medications and infusion therapies. They offer treatment in patients' homes, in providers' offices, or at one of their many nationwide infusion centers. Soleo Health specializes in treating complex and ultra-rare diseases with a focus on improving patient quality of life and optimizing health outcomes. They work closely with patients, providers, pharmaceutical manufacturers, payors, and health systems to deliver high-cost therapies, demonstrating value through real-world outcome data. Soleo Health is recognized for its clinical excellence and dedication to patient care, and offers nationwide services, including an online portal, Soleo Connect®, for real-time communication.

📋 Description

• Support the intake and reimbursement teams in the area of commercial contracting and government programs. • Research payor contracts and other published information. • Publication and maintenance of resource documents. • Communication with provider relation teams to resolve contract and/or regulation non-compliance. • Review payor contracts for intake and reimbursement contract terms (e.g., timely filing, clean claim payment terms) and comprehensive fee provisions/fee schedules common billable services (e.g., per diems, nursing and drugs). • Work with Managed Markets team to address missing or unfavorable contract terms. • Provide comprehensive analyses of missing or unfavorable terms to VP of Reimbursement and CFO. • Provide payor education to intake and reimbursement teams. • Create, maintain, and manage all Intake and Reimbursement contract resource documents. • Cultivate effective working relationships with contracted and non-contracted insurance Provider Relations personnel. • Identify opportunities for cost savings and cash collections through payer reimbursement analysis/trends. • Complete managerial tasks for direct reports including hiring, training, and performance management.

🎯 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.

🏖️ Benefits

• 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