Position Summary
The Single Case Agreement (SCA) Specialist is responsible for securing reimbursement and coverage for services, therapies, or medical technologies on a patient-by-patient basis through negotiation with health plans. This role serves as a key liaison between providers, payers, patients, and internal teams to ensure timely access to care when standard coverage pathways are not available.
About RomTech
ROMTech® is a groundbreaking telemedicine technology with remote clinical oversight and fully customizable therapy protocols. The PortableConnect® (the device) enables gentle, therapeutic movement within a comfortable range of motion. Light, easy, and frequent sessions make it easier for the body to heal and recover. The result: patients recover and return to their activities of daily living more quickly, with less pain and drugs, and with better mobility.
Key Responsibilities
o Initiate and lead negotiations with commercial and government health plans to establish Single Case Agreements (SCAs)
o Secure appropriate reimbursement rates, terms, and coverage conditions for out-of-network or non-contracted services
o Communicate clinical and economic value propositions to payer medical directors and contracting teams
o Manage a pipeline of patient-specific cases from intake through agreement execution and reimbursement
o Coordinate with clinical, reimbursement, and intake teams to gather necessary documentation (e.g., medical necessity, prior authorizations)
o Track case progress, timelines, and outcomes to ensure timely patient access
· Documentation & Compliance
o Draft, review, and finalize SCA contracts in collaboration with legal and compliance teams
o Ensure all agreements adhere to payer requirements, regulatory standards, and internal policies
o Maintain accurate records of negotiations, approvals, and contract terms
· Cross-Functional Collaboration
o Partner with providers, revenue cycle teams, and patient access teams to align strategy and communication
o Educate internal stakeholders on payer requirements, negotiation strategies, and SCA processes
o Serve as a subject matter expert on reimbursement pathways for non-covered or out-of-network services