Payor Enrollment Specialist

Soleo Health is seeking a Payor Enrollment Specialist to drive the end-to-end credentialing process, ensuring timely payor enrollment, including support for Medicare enrollment and ongoing compliance to support our Specialty Infusion Pharmacy. Join us in Simplifying Complex Care!

Previous experience with pharmacy facility enrollment and payer credentialing required.

Soleo Health Perks:  

• Competitive Wages   
• 401(k) with a Match 
• Referral Bonus    
• Paid Time Off 
• Great Company Culture  
• Annual Merit Based Increases 
• No Weekends or Holidays   
• Paid Parental Leave Options 
• Affordable Medical, Dental, & Vision Insurance Plans 
• Company Paid Disability & Basic Life Insurance 
• HSA & FSA (including dependent care) Options 
• Education Assistance Program   

The Position:

The Payor Enrollment Specialist is responsible for managing and supporting all aspects of payor enrollment with provider, facility, and/or pharmacy payors, including commercial payors, pharmacy benefit managers (PBMs), and other third-party organizations. This role works collaboratively with the Credentialing team and serves as a backup resource for Medicare and Medicaid enrollment activities to ensure continuity of operations.

This position requires strong organizational skills and experience navigating pharmacy payor requirements, enrollment portals, and documentation standards. The Payor Enrollment Specialist plays a key role in maintaining accurate records, supporting timely application submissions, and ensuring ongoing compliance with payor requirements. Through effective coordination and attention to detail, this role helps ensure uninterrupted reimbursement and operational alignment across the organization. Responsibilities Include:

• Manage and coordinate new and ongoing payor enrollment activities for pharmacy-related payors, including commercial insurance carriers, pharmacy benefit managers (PBMs), third-party administrators, and preferred provider organizations. 
• Lead the planning, preparation, and submission of payor enrollment and re-enrollment applications, ensuring accuracy, completeness, and adherence to established timelines. 
• Serve as a backup support resource for Medicare and Medicaid enrollment and maintenance, assisting with applications, revalidations, and updates as needed. 
• Maintain and organize all documentation required for payor enrollment, including licenses, certifications, disclosures, policies, and supporting materials. 
• Track enrollment statuses, recredentialing cycles, contract amendments, and ongoing requirements using master payor lists, shared drives, and internal tracking tools. 
• Support the completion of addendums, new location enrollments, re-credentialing submissions, annual FWA training attestations, and other payor-specific documentation. 
• Monitor changes to payor enrollment requirements and pharmacy payor standards; communicate updates to internal stakeholders and assist with implementation. 
• Manage user access to enrollment portals and ensure appropriate permissions are maintained. 
• Collaborate with Payor Relations, Credentialing, and leadership teams to follow up on outstanding applications and resolve payer inquiries. 
• Provide administrative and organizational support for additional credentialing and enrollment-related tasks as assigned. 
• Perform other related duties as needed to support departmental and organizational objectives.
• Work with Directors Payor Relations and others as applicable to follow up on outstanding credentialing applications and proposals. Provide expert advice and support for departmental and organizational projects that require credential insight.
• Collaborate with the Credentialing team to set quality standards for services and products. Ensure that all credential activities contribute to the overarching goal of high-quality service delivery.
• Contribute expertise to larger, cross-functional projects, offering support and guidance on issues related to credentialing. Participate in strategic meetings to represent the credentialing perspective and ensure alignment with organizational objectives.
• Perform an internal audit process within payor enrollment.

Schedule:

• Monday-Friday 8:30am-5pm, standard business hours

• Previous experience with pharmacy facility enrollment and payer credentialing required.
• Credentialing certifications like CPCS, CPMSM, & CPES are preferred, not required.
• High School Diploma or higher required.
• Experience establishing and maintaining relationships with individuals at various levels of the organization, such as peers, internal/external stakeholders, business partners, senior level managers.
• Demonstrated competencies in the use of information support systems (e.g. PECOS, Smartsheet, Microsoft Word, Payor enrollment platforms, Licenstrak, Excel, PowerPoint, and Outlook.
• Certification in payor enrollment or healthcare credentialing is preferred but not required; relevant experience in pharmacy payor enrollment may be substituted.

About Us: Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference! 

Soleo’s Core Values:

• Improve patients’ lives every day 
• Be passionate in everything you do 
• Encourage unlimited ideas and creative thinking 
• Make decisions as if you own the company 
• Do the right thing 
• Have fun! 

Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture.   

Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor. 

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