Requisition Number: COMME02166
What you’ll be doing:
Responsible for execution and administration of contractual documents that establish business relationships with managed care providers and specialized administrative support to relieve Managed Care Managers. Review contracts to ensure compliance to company policy, government specifications and other requirements.
Who we are:
Here at Tandem, Diabetes is all we do and we are dedicated to making the lives of people with diabetes better and better, through relentless innovation. “In Tandem” means together, and we strive to embody that in every aspect of our business. We believe that working in tandem, not in isolation, is the best way to continually exceed expectations.
We’ve have been named one of the fastest growing insulin pump companies in the U.S! Why? Designed, assembled and supported from our San Diego, CA headquarters, Tandem has created the simple-to-use t:slim X2 Insulin Pump with Control-IQ Technology, which is the smallest pump available, the only color touch-screen insulin pump capable of remote feature updates, and the first CGM-enabled pump approved to let users make treatment decisions without pricking their finger.
Read more about our company & culture here: and see what our customers are saying here: #tsliminthewild
What you need for this position:
PRIMARY DUTIES & RESPONSIBILITIES:
- Upload commercial contract matter into Legal Tracker according to guidelines, manage the routing process, supporting documents upload and status reports.
- Coordinate contract review process & coordinate contract review meetings with legal counsel and senior management and MCM. Work closely with Managed Care team, Finance, Legal to assure timely execution of insurance contracts.
- Assist MCMs in special circumstances with large accounts in the initial drafts & applications of various types of contracts (e.g. Health Plan, State & Managed Medicaid, Supplemental, IPA, Medical Group, TPA, Commercial Insurance Networks).
- Load non-contracted Networks, Payors and Plans into CRM for IVS and ISS to link a customer being processed through distributors.
- Coordinate Hand Off of executed contract between the MCM, IVS and ISS leads.
- Generate monthly sales reports for ROI analysis with VP, Global Market Access.
- In conjunction with Vice President, Global Market Access & MCMs – Review and obtain contract requirements, special provisions, terms and conditions to ensure compliance with appropriate laws, regulations, corporate policies and business unit procedures.
- Maintaining a variety of company policy and procedures required in credentialing matters.
- Correspond with payors as needed such as a payor requesting additional application documents.
- Track renewal of state and business licenses, coordinating with Associate Director, Customer Operations.
- Consistently manages data information exchange for efficient processing (e.g. CRM maintained to identify direct access through MCO, network or distributor). Manage fee schedules, payor database, contracts in CRM system, and update distribution list of networks & plans).
- Ensure work is performed in compliance with company policies including Privacy/HIPAA and other regulatory, legal, and safety requirements.
- Continuously seek to improve systems, evaluates processes and methods and recommends best practices.
Knowledge, skills & abilities:
- Ability to read and follow procedures and flow diagrams.
- Proficient call handling skills.
- Skilled at presenting information in a clear, concise manner to all levels within the department.
- Skilled at contributing on a consistent basis to team initiatives in a thorough and timely manner.
- Able to react to changing situations in a timely, calm, and confident manner.
- Proficient with MS Office suite (Word, Excel, Outlook), and Internet.
- Knowledgeable of the (CRM) systems a plus.
Minimum certifications/educational level:
- Bachelor’s degree or equivalent combination of education and applicable job experience.
- 2-3 years’ experience in a customer service or sales support.
- Experience managing large database imports preferred.
What’s in it for you?
We’ve got you covered. We offer a robust benefits package to support your health and your family. From medical, dental, and vision, to flexible spending accounts for both health and dependent care – Tandem’s got you covered!
Stay well with us. Enjoy the outdoors during your workday by biking, running, or walking on one of our nearby trails. Or check out our offsite gym, which boasts luxurious amenities including specialty fitness classes and state-of-the-art equipment.
Invest in your career. Tandem offers all employees access to training and development programs and courses to help keep your career and skillset updated, not outdated.
Live your life. Relax with 20 days of paid time off and celebrate 10 paid holidays in your first year. Save for your future with a company-provided 401(k) plan. Look forward to saving money on tickets to the San Diego Zoo, movies, restaurants, and so much more with our exclusive employee discount program.
Celebrate in Tandem. Join in monthly employee get-togethers, tacos for Cinco de Mayo, corned beef for St. Patrick’s Day, costume-contest for Halloween, and the annual JDRF walk.