Contract System Management Analyst

Job not on LinkedIn

🔥 50 minutes ago

🌾 Nebraska – Remote

🌾 Nebraska – Remote

💵 $46.1k - $76.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Business Analyst

👻 Ghost score 0%

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Option Care Health

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1987

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare • 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

• Create and build records for third party payer contract agreements, including insurance plans, business rules, and contract pricing terms • Maintain assigned payer agreements and update pricing, coding, and business rules • Work with Contracting and Revenue Cycle Management on site integration to ensure insurance plans are accounted for and assigned to the correct location • Identify contracts that are not generating revenue and assess opportunities to purge records and reduce insurance plan selection errors • Audit third party agreement pricing tables for accuracy • Collaborate with Pricing to ensure proper insurance plans are utilized and maximize profitability • Collaborate with IT and Revenue Cycle Management on system upgrades and recommend system enhancements • Ensure proper insurance plans are set up and usable by CMC • Provide advanced system reports for revenue cycle management and pricing teams regarding payer pricing strategies • Assist with training Contract System Management Specialists • Prepare, research, interpret, and load third party payer agreements into the CPR Plus pharmacy management system • Facilitate cross-functional collaboration with Contracting, Pricing, Trade, Revenue Cycle Management, Contract Operations, and CMCs

🎯 Requirements

• Bachelor’s degree, or High School Diploma with at least 5 years of experience in Revenue Cycle Management, Contract Management, Home Infusion intake, or home infusion pharmacy technician • Ability to work in a deadline driven environment • Strong analytical and problem solving skills • Ability to function individually as well as in cross-functional teams • Ability to identify improvement and growth opportunities • Advanced level skill in Microsoft Excel, including VLOOKUP, basic formulas, and pivot table work • Experience with analyzing and reporting data; ability to identify issues, model trends, or exceptions to drive improvement of results and find solutions • Experience with HCPCS coding and Drug Pricing Sources (AWP, ASP, WAC) • Intermediate level skill in Microsoft PowerPoint and Microsoft Word • Willing to travel up to 10% of the time for business purposes (within state and out of state) • CPR Plus experience • Contract Management experience • Experience with Medicare, Medicaid, PBM, and other third party payer payment guidelines

🏖️ 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