LifeNet Health is searching for talented individuals who will embrace our mission of saving lives, restoring health, and giving hope.
LifeNet Health, headquartered in Virginia Beach, Virginia, is the largest nonprofit organ procurement organization (“OPO”) and tissue processor in the United States, as well as a leading innovator in tissue engineering and regenerative medicine. Our goal is to improve the quality of human life through the provision of organs, tissues and cells for transplantation; to provide innovation in the fields of bio-implants, regenerative medicine and research; and, to serve the community with educational and support services that enhance the donation process. LifeNet Health has over 1200 employees and has a growing global presence.
How You Will Contribute To LifeNet Health’s Success
The Manager, Reimbursement Services is responsible for managing, overseeing, and coordinating the daily activities of Field Reimbursement and Medical Authorization Specialists. Partners with Marketing and Sales leadership on overall account and territory strategies to maximize internal/external customer knowledge on payor policy and processes. Responsible for providing access and reimbursement education to internal and external stakeholders, including medical policies, prior authorization requirements, coding and billing, product access and site of care options and restrictions, with the goal of minimizing barriers to healing. Responsible for all activities related to benefit investigations, obtaining prior authorization, denials, appeals, and preparing the claims for submission for the company’s products and services.
What You’ll Do
People Management: Provides oversight to assigned team by supervising, guiding, and directing employees to be effective team members. Ensures that everyone is equipped with the appropriate skills, tools, and talents necessary for executing their duties. Uses the established people processes (performance, development, succession, and career) to ensure that their team’s level of performance and capabilities meet current and future standards. Establishes and utilizes new or existing programs and/or resources to manage employee engagement, motivation, recognition, and retention.
Field Relationship Management: Develops and maintains professional business relationships with key contacts, payer decision makers, customers, and stakeholders. Monitors national and local healthcare payer policies, develop relationships with key advocacy leaders, state societies, and provide direct support to prescribing physicians, hospitals and support staff regarding reimbursement and product access and reimbursement dynamic within payer channels.
Planning & Execution: Works in collaboration with key Sales, Marketing, Finance, and Administrative Team stakeholders to develop and implement reimbursement service strategies that ensure patients have a best-in-class experience throughout the reimbursement process for assigned products. Ensures that the team is prepared for future LifeNet Health growth and new product introductions.
Process Improvement: Proactively identifies opportunities for improved processes, performance, and metrics. Collaborates with relevant stakeholders to resolve issues; gather, analyze, and interpret data to determine root cause of errors and implement appropriate correction actions / issue resolution.
KPI Management: Identifies errors and creates solutions that increase accuracy, efficiency, service, productivity, and customer experience for our clients. Collects required report data for department and prepares weekly, monthly, and ad hoc metric reports.
What You’ll Bring (Minimum Requirements)
Bachelor's Degree in Business or a related field
Five (5) years of experience in a leadership role managing direct reports
Five (5) years of experience in medical reimbursement or a related healthcare field
Two (2) years of reimbursement processing, claims submission, & claims appeals experience
Preferred Experience/Skills/Certifications
One (1) year of experience medical device reimbursement experience
These Would Be Nice Too (Knowledge Skills And Abilities)
Communication Skills: Excellent verbal and written communication skills; ability to communicate and build relationships with all professionals at different levels within the organization.
Time Management: Ability to prioritize multiple, competing priorities and manage time/workload. Demonstrated ability to effectively prioritize and juggle multiple time sensitive projects, multi-task, identify project interdependencies and potential risks/pitfalls.
Attention to Detail: Ability to perform tasks thoroughly and with care; checks work to ensure high degree of accuracy/completeness and early/on-time delivery.
Proficient in Microsoft Office: PowerPoint, Excel, Word, Outlook, Microsoft Suite.
Relationship Building: Ability to build trust and operate with a sense of humor, humility, courage, passion, and integrity for the benefit of the organization.
Why work at LifeNet Health?
We have a fierce drive for our mission of Saving Lives, Restoring Health, and Giving Hope. You will not find another company with a culture as strong as ours.
403(b) and Profit Sharing Plan
Affordable medical, dental, and vision coverage
Corporate sponsored events for employees
Work-life balance with generous paid time off to include vacation time, sick time, and paid holidays
Tuition reimbursement
Personal career, skill, and leadership development opportunities
Wellness Program (gym reimbursement, monthly wellness webinars, mental health toolkit, financial resources, and much more)
Employee Assistance Program (EAP) for employees and members of their household
Dedicated and passionate co-workers
The pay rate for the successful candidate will depend on geographic location and the candidate’s qualifications and prior relevant experience. The pay range for this position is $85,516 annually (entry- level qualifications) to $142.526 annually (experienced in this role). *
Actual compensation may be higher based on the successful candidate's knowledge and relevant experience.
This position is eligible for an annual bonus once eligibility criteria are met.
All benefits are subject to eligibility requirements and LifeNet Health reserves the right to modify or change these benefits programs at any time, with or without notice, unless otherwise required by law. Further, nothing in this posting is intended to alter the “at will” relationship of a successful candidate and this posting does not constitute a specific promise.
We are proud to be an EEO/AA employer EOE/M/F/Disability/Vet. We maintain a drug-free workplace and perform pre-employment substance abuse testing.
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
General Business, Administrative, and Customer Service
Industries
Medical Equipment Manufacturing, Biotechnology Research, and Hospitals and Health Care
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