The Copay Vendor Manager is responsible for the oversight and coordination of copayment vendor activities, ensuring effective management of copayment programs. This position involves maintaining relationships with copayment vendors, resolving issues, and optimizing copayment processes. This position will participate in other related project and perform other functions as may be required from time to time.
Primary Duties and Responsibilities:
- Manage relationships with copayment vendors, including negotiation of contracts and service level agreements.
- Ensure compliance with copayment regulations and guidelines set forth by regulatory bodies.
- Troubleshoot and resolve any issues related to copayment processing, billing, or vendor services.
- Conduct regular audits of copayment programs to identify areas for improvement and cost savings opportunities.
- Collaborate with cross-functional teams to identify and implement process improvements related to copayment management.
- Analyze copayment data and trends to make recommendations for optimizing copayment programs.
- Develop and maintain copayment program documentation, including policies and procedures.
- Train internal staff on copayment processes and procedures.
- Monitor copayment vendor performance and address any performance issues or concerns.
- Stay informed about industry trends and best practices in copayment management to ensure continuous improvement.
Experience and Education Requirements:
- Healthcare Copay knowledge strongly considered.
- Ensure program is meeting contractual obligations.
- Provides day-to-day instructions to team members on job responsibilities.
- Helps associates resolve associate work-related issues.
- Supports new associates in their efforts for growth and development.
- Participates in the hiring and termination process.
- Develops designs and conducts Train the Trainer program.
- Provides feedback up and down the organization (Positive and Constructive).
- Participates in client meetings; prepares agenda and / or takes meeting notes.
- Ensures open communication with program support.
- Translates and oversees organizational strategies for assigned goals.
- Identifies client issues; receives and triages client requests.
- Proactively identifies program issues and proposes ways in which to address their concerns.
- Maintains positive rapport with client.
- Understands the billing process and contractual obligations.
- Participates in budget planning.
- Accountable for program quality and compliance with standard operating procedures.
- Designs project task plan and standard operating procedures.
- Analyzes reports for trends and gives recommendations.
- Analyzes progress of tactical issues.
- Reports all Adverse Events (AE) disclosed in alignment with training and Standard Operational Procedures (SOP)
- Performs related duties as assigned.
Minimum Skills, Knowledge, and Ability Requirements:
- Previous 4+ years of experience in CoPay Vendor Management, Hub Operations, specialty pharmacy, physician’s office, medical insurance, healthcare setting, and/or related experience.
- Previous 2+ years supervisory experience is required.
- Bachelor’s degree highly desired
- Outstanding interpersonal and interdepartmental skills in a multicultural environment
- Strong written/verbal communication skills for interviewing Subject Matter experts to extract.
- Excellent ability to advise and influence in a client-facing environment.
- Excellent multi-tasking and organizational skills, with the ability to balance multiple responsibilities and competing priorities simultaneously.
- Passionate about thriving in a rapidly changing, time-critical environment, to quickly adapt to changing business needs and processes.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this job, the employee is regularly required to sit.
- The employee must occasionally lift and/or move up to 10 pounds.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.
Schedule.
Must be flexible on schedule and hours
Travel may be required
CareMetx considers equivalent combinations of experience and education for most jobs. All candidates who believe they possess equivalent experience and education are encouraged to apply.
At CareMetx we work hard, we believe in what we do, and we want to be a company that does right by our employees. Our niche industry is an integral player in getting specialty products and devices to the patients who need them by managing reimbursements for those products, identifying alternative funding when insurers do not pay, and providing clinical services.
CareMetx is an equal employment opportunity employer. All qualified applicants will receive consideration for employment and will not be discriminated against based on race, color, sex, sexual orientation, gender identity, religion, disability, age, genetic information, veteran status, ancestry, or national or ethnic origin.
