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Extraordinary Careers. Endless Possibilities.

With the nation’s largest home infusion provider, there is no limit to the growth of your career.

Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team members including 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and team members.

Join a company that is taking action to develop an inclusive, respectful, engaging and rewarding culture for all team members. At Option Care Health your voice is heard, your work is valued, and you’re empowered to grow. Cultivating a team with a variety of talents, backgrounds and perspectives makes us stronger, innovative, and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a culture that attracts, hires and retains the best and brightest talent in healthcare.

Job Description Summary:

Manage the negotiation, preparation, financial analysis, business review, and implementation of assigned Managed Care clients, facility compounding agreements for home and alternate site infusion services provided by Option Care. . Responsible for non-strategic managed care plans with less than 250K lives and typically less than $1,000,000 in annual revenues, but may include national network or workers compensation agreements, and non-financial amendments for all managed care clients as assigned by the Contracting Director for the territory. Resolve reimbursement issues arising from contract compliance issues for assigned regions when escalated by Revenue Cycle Management team. Handle day to day issues that may arise out of existing contractual relationships with managed care payers. Additionally, will help support credentialing overflow as a back-up the credentialing coordinator.

Job Description: ​

Job Responsibilities (listed in order of importance and/or time spent)

Manage the negotiation of provider and Facility contracts in accordance with company guidelines for assigned geography for home and alternate site infusion therapy services provided by Option Care

Manage internal implementations of assigned agreements with regional intake, operations, and revenue cycle teams in order to insure success of clean claims payment.

Manage external implementations and foster ongoing relationships with assigned accounts

Subject Matter Expert for CPR+ Shared Contract and Insurance records and work with Contract System Management Analysts providing direction on new contract builds or changes.

Manage communication with assigned accounts as it relates to demographic changes to Option Care Facilities to insure health plan agreements are current in order to facilitate clean claim billing.

Initiate and lead meetings with health plans and corporate teams, including Managed Markets and Contracting leadership, to review provider agreement performance data and scorecards. Informs contracting leadership of contract risks for assigned third party contracts. 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 reimbursement issues identified by Payer Liaisons that may be related to contract compliance.

Recommends strategies to update and grow a sales representative’s understanding of the scope and intent of assigned managed care or facility contracts. Attends client meetings where appropriate and in collaboration with assigned managed markets representative.

Maintains successful working relationships with internal departments such as Infusion Operations, Legal, Sales, and any other departments that are involved with or impacted by managed care contracts.

Utilize and participate in deployment of new contract management system

Complete credentialing applications when necessary for new contract access as back up to contract coordinator.

Initiate monthly meetings with assigned Contracting Mentor(s) for development opportunities

Participate in regional meetings as directed by VP, Contracting

Supervisory Responsibilities

Does this position have supervisory responsibilities?

(i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.)

No X

Yes

Basic Education and Experience 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.

Basic Qualifications & Interests (BQIs)

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).

Travel Requirements: (if required)

Willing to travel up to 25% of the time for business purposes (within state and out of state).

Preferred Qualifications & Interests (PQIs)

Bachelor's degree and 3-5yrs of experience in managed care contract management within the health care industry.

This job description is to be used as a guide for accomplishing Company and department objectives, and only covers the primary functions and responsibilities of the position. It is in no way to be construed as an all-encompassing list of duties.

Due to state pay transparency laws, the full range for the position is below:

Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.

Pay Range is $78,973.32-$131,614.70

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

Option Care Health subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information.

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For over 40 years, Option Care Health has provided adult and pediatric patients with an alternative to hospital infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high-quality infusion services for nearly all patients with acute and chronic conditions across the United States, resulting in high quality outcomes at a significantly reduced cost. Option Care Health has more than 70 infusion pharmacies and 100 alternate treatment sites. We are guided by our purpose to provide extraordinary care that changes lives through a comprehensive approach to care along every step of the infusion therapy process including: intake coordination, insurance authorization, resources for financial assistance, education and customized treatments.