Soleo Health is seeking a Reimbursement Contract Specialist to work Remotely (USA). Join us in Simplifying Complex Care!

What We Have to Offer You:

• Competitive Wages
• 401(k) with a match
• Referral Bonus
• Annual Merit Based Increases
• No Weekends or Holidays!
• Affordable Medical, Dental, & Vision Insurance Plans
• Company Paid Disability & Basic Life Insurance
• HSA & FSA (including dependent care) options
• Paid Time Off
• Education Assistant Program

The Position:

The reimbursement Contract Specialist supports Reimbursement Contract Management with payor contract review and provides guidance to stakeholders on payor contract information. This requires management of internal resources pertaining to contract reimbursement information and a high level of written and oral communication with a broad range of stakeholders.

• Assists Reimbursement Contracts Manager in review of payor contracts and amendments.
• Provides consultation, education and training on contract requirements to Intake and Reimbursement teams. In addition, provides timely and accurate information regarding payor reimbursement methodologies, rates and policies.
• Works cross-functionally to ensure contract related information is disseminated to appropriate staff upon execution of contracts.
• Manages payor contract and amendment reimbursement related reference materials and other supporting documentation on company intranet sites.
• Works cross-functionally to ensure contract or amended rates and payor information is loaded accurately by the appropriate team for authorization, billing and claims functions.
• Prepares reports and assists with special projects.
• In collaboration with leadership, investigates payment variances for payor contract non-compliance.
• Regularly communicates with billing & collections teams to review payor payment trends.
• Partners with key stakeholders to identify and achieve priorities, goals and objectives.
• Other duties as assigned by manager

• A minimum of 4 recent years of experience in Home Infusion, Specialty Pharmacy, or closely related field. This should include experience with reimbursement contracts.
• Advanced knowledge of health insurance plans: Managed Care Organizations, PPO, POS, Self-Funded, TPAs and providers at financial risk (hospital/health systems, medical group/IPA).
• Knowledge of HIPAA guidelines, federal, state, and local regulations related to pharmacy or healthcare providers.
• Proficiency in Microsoft Excel
• Experience with CPR+ system preferred
• Ability to assist in training and education of staff
• Ability to manage multiple priorities
• Ability to work independently

As a condition of hire, full dosage of the COVID-19 vaccination is a requirement for this position. Soleo Health will consider accommodation for disability/medical and/or sincerely held religious beliefs.

About Us: Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference!?

Soleo’s Core Values:

• Improve patients’ lives every day
• Be passionate in everything you do
• Encourage unlimited ideas and creative thinking
• Make decisions as if you own the company
• Do the right thing
• Have fun!

Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture.

Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.

Keywords: contract specialist