Subject Matter Expert, Infusion Services

CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services.

Job Details:

We are seeking an experienced Subject Matter Expert (SME) in Infusion Operations to support our internal teams and prospective clients in building, optimizing, and scaling high-performing infusion programs. The ideal candidate will have extensive infusion experience, deep knowledge of accreditation standards, operational best practices, and strategies to drive financial and clinical performance.

The SME guides the company on strategic Operations Management / Finance Operations decisions and provides advice that has a significant impact on strategic planning. Possesses industry-wide authority and represents the organization externally. Recognized as an expert within the organization and has in-depth and/or breadth of expertise in own discipline and broad knowledge of other disciplines within the function. Recommends process, product or service improvements. Solves unique and complex problems that have a broad impact on the business. May influence business processing, service levels and reporting efforts around key statements and document related to business operations / Finance Operations or key accounts. Ensure that production levels and targets are achieved and effective processing controls are in place. Widely recognized Business Operations / Finance Operations expert and thought leader by both internal and external community and is responsible for the technical leadership of a major department/multiple departments across a function.

This role will serve as a trusted advisor and educator, helping shape internal product development, go-to-market strategies, and customer engagement models.

Key Responsibilities

Operational Expertise & Education

Serve as the internal and external expert on all aspects of infusion operations.

Educate internal teams and clients on accreditation requirements, renewals, and compliance best practices (e.g.,ACHC).

Train teams on core patient management workflows, including:

• Managed Care Contracting processes
• Benefits verification and eligibility management
• Prior authorization submission and follow-up
• Financial assistance and copay program navigation
• Patient counseling and ongoing clinical support
• Home Health Support

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Revenue Cycle & Business Performance

• Provide guidance on revenue cycle management (RCM) processes, including claim submission, denial management, and payment optimization.
• Develop and recommend strategies to improve reimbursement, minimize revenue leakage, and enhance financial outcomes.
• Advise on performance metrics, benchmarking, and reporting frameworks.
• 340B & Payer Strategy
• Advise on effective 340B capture strategies, contract pharmacy models, and compliance considerations.
• Support payer and manufacturer engaement strategies that align with specialty therapy access and reimbursement goals.
• Strategic & Commercial Support
• Collaborate with product management and commercial teams to define differentiated service offerings and value propositions.
• Contribute to the development of go-to-market strategies for new products and services within the specialty pharmacy vertical.
• Participate in client presentations, proposals, and solution design sessions as a trusted subject matter expert.

Qualifications

Experience: Minimum of 8–10 years of progressive leadership experience in infusion operations, preferably in both payer and provider settings.

Education: Bachelor's degree in Pharmcy, Healthcare Administration, or related field (PharmD or MBA preferred).

Expertise:

• Deep understanding of accreditation standards (ACHC).
• Proven experience managing patient access programs, benefits verification, prior authorization, and patient support workflows.
• Strong knowledge of revenue cycle management processes and financial performance levers.
• Familiarity with 340B program operations and capture optimization.

Skills:

• Excellent communication and presentation skills, with the ability to translate complex operations into actionable insights.
• Collaborative and strategic thinker, capable of influencing internal stakeholders and external clients.
• Proficient with specialty pharmacy management software, workflow tools, data analytics platforms and Salesforce.com

CarepathRx offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire.

CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.