This is a payer-contract and reimbursement strategy role built for someone who knows specialty pharmacy or home infusion inside and out. You’ll dig into contract terms, spot what’s missing or unfavorable, educate internal teams, and work with payer/provider relations to reduce denials, improve collections, and stay compliant.
About Soleo Health
Soleo Health is a national provider of specialty pharmacy and infusion services delivered in the home or alternate sites of care. Their focus is simplifying complex care while improving outcomes, backed by a culture centered on accountability, passion, and doing the right thing.
Schedule
- Full-time, remote
- Typical business hours: 8:30am–5:00pm (overtime as needed)
- No weekends or holidays
What You’ll Do
- Review payer contracts for key intake and reimbursement terms (timely filing, clean claim payment terms, fee provisions and fee schedules)
- Analyze fee schedules for common billable services (per diems, nursing, drugs)
- Partner with Managed Markets to address missing or unfavorable reimbursement terms
- Deliver clear analyses and recommendations to leadership (VP of Reimbursement and CFO or designees)
- Educate intake and reimbursement teams on payer policies, trends, and reimbursement practices
- Create and maintain reimbursement contract resource documents for internal use
- Build and maintain relationships with provider relations teams (contracted and non-contracted)
- Address trending issues like claim denials or payer non-compliance with contract terms
- Identify cost savings and improved cash collections through reimbursement trend analysis
- Contribute to internal/external discussions on payer strategy, contracts, and industry knowledge
- Manage direct reports (hiring, training, performance management, reviews, conflict resolution, goal setting, and strategic planning)
- Handle additional duties as assigned
What You Need
- High school diploma or equivalent (required)
- Bachelor’s degree OR 5+ years of reimbursement/account management experience with injectable/infused drugs or reimbursable medical device products
- Significant specialty pharmacy or home infusion experience (required)
- Proven experience with Medicare, Medicaid, and/or managed care reimbursement at both provider and payer levels
- Strong communication skills (verbal and written)
- Strong analytical, organizational, administrative, and team-building skills
- Solid problem-solving ability and comfort working cross-functionally
Benefits
- Pay: $70,000–$88,000/year
- Competitive wages
- 401(k) with match
- Referral bonus
- Paid time off
- Annual merit-based increases
- Paid parental leave options
- Medical, dental, and vision insurance plans
- Company-paid disability and basic life insurance
- HSA & FSA options (including dependent care)
- Education assistance program
- Great company culture
If you’ve got real home infusion/specialty pharmacy reimbursement chops and you like being the person who fixes the system behind the scenes, this is a serious opportunity.
Know the contracts. Protect the margin. Keep care moving.
Happy Hunting,
~Two Chicks…