Director, Reimbursement

Job ID: 10509Position Title: Director, ReimbursementWorking Location: Illinois-Buffalo GroveEmployment Status: Full-Time RegularRequired Experience: 5 yearsRequired Education: Bachelors DegreeJob Description:Optioncare, a wholly owned subsidiary of Walgreens, specializes in providing comprehensive care to patients with acute and chronic conditions in their homes, ambulatory treatment centers and physician offices. Its services include intake coordination, benefits and reimbursement support, medication fulfillment and administration, compliance and patient education, one-on-one care and customer service. Skilled nurses and pharmacists are accessible 24/7 to deliver and manage complex infusion and injectable therapies from more than 100 OptionCare home infusion and specialty pharmacies in 35 states. OptionCare’s services also include respiratory and home medical equipment at some locations. Walgreen Co. is the nation’s largest drugstore chain with fiscal 2007 sales of $53.8 billion. The company operates more than 6,100 stores in 49 states and Puerto Rico, including 77 Happy Harry’s stores in Delaware and surrounding states. Walgreens is expanding its patient-first health care services beyond the traditional pharmacy through Walgreens Health Services, its managed care division, and Take Care Health Systems, a wholly owned subsidiary that manages convenient care clinics at drugstores. Walgreens Health Services assists pharmacy patients and prescription drug and medical plans through Walgreens Health Initiates Inc. (a pharmacy benefit manager), Walgreens Mail Service Inc., Walgreens Home Care Inc., and Walgreens Specialty Pharmacy LLC.Essential Skills:The Director of Reimbursement is responsible for the overall reimbursement function including policy development and training. This position is also responsible for monitoring payers and providing direction to individual branch locations. This person will also provide oversight and direction to the Corporate Reimbursement Team. Direct the development and maintenance of the reimbursement function policies and procedures for OCE and OptionMed including Specialty Care Pharmacy. Develop systems for monitoring national payer receivable trends, including United Healthcare, Aetna, and other major payers. Perform monitoring function and provide trend reports with assessment of the trends to management. Manage the Corporate Medicare Reimbursement function, providing expertise and direction to assist branch offices in maximizing reimbursement and minimizing bad debt write-offs relating to government payers. Monitor changes in governmental reimbursement policies and provide leadership in strategic planning to accomodate changes in reimbursement regulations. Conduct training programs on the branch, regional and national level, as required. Direct the development of training programs for Reimbursement Managers and the Reimbursement staff at the branch office level. Manage the Corporate Reimbursement Specialist team responsible for assisting branch offices in billing and collection of accounts receivable in specific situations wherein an office is in need of extra resources due to problem receivable situations, temporary staffing shortages, or other circumstances. Manage the EDI function as it relates to electronic claims submission, electronic payments, and related systems. Maximize utilization or EDI capabilities, to enhance cash flow. Provide Corporate reimbursement direction and resources for start-up implementation of the i-emphsys system at branch offices, to ensure a smooth transition and uninterrupted cash flow. Manage Corporate Reimbursement processing of centralized receipt of payments and correspondence. Qualifications:Minimum Requirements:Bachelor degree in business or related field Five to ten years managerial healthcare reimbursement experience, specifically in home IV therapy / DME Experience and expertise in Medicare, Medicaid, Managed Care, and commercial insurance carriers Experience with reimbursement systems and ability to learn and adapt to new systems High degree of competency with Microsoft Office software Excellent interpersonal and communication skills (both written and verbal) Ability to manage people and work with all levels of management Presents a professional image to internal and external customers Ability to travel Excellent problem solving skillsPreferred Qualifications:MBA in Business or related field. Company: Walgreens Location: Buffalo Grove, IL Status: Full Time, Employee Job Category: Accounting/Finance/Insurance Career Level: Manager (Manager/Supervisor of Staff) Education Level: Bachelor's Degree Company: Walgreens Reference Code: PCK347-39478