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Senior Contract Manager Managed Care

Key Facts

Remote From: 
Full time
Senior (5-10 years)
English

Other Skills

  • Data Reporting
  • Microsoft Office
  • Accountability
  • Communication
  • Leadership
  • Assertiveness
  • Team Management
  • Organizational Skills
  • Analytical Thinking
  • Detail Oriented
  • Relationship Building
  • Problem Solving

Roles & Responsibilities

  • 5+ years of experience in Managed Care, hospital revenue cycle, or payer-provider relations
  • Associates degree required; Bachelor's degree preferred
  • High degree of competency in contract language interpretation and analytical problem-solving
  • Proficiency in Microsoft Office and experience with Epic systems preferred

Requirements:

  • Lead and mentor the Contract Management team; provide training, set schedules, and evaluate performance to maintain high standards
  • Maintain the digital contract database with current information, including contract language and rate updates; coordinate with payers to ensure timely rate implementation and report data to leadership
  • Coordinate with payers and serve as a liaison across departments for payer policy updates, operational changes, and governmental initiatives; facilitate education and issue resolution
  • Analyze payer data and trends to identify root causes of AR issues; support month-end net revenue calculations and chair quarterly Joint Operation Committee meetings with revenue cycle stakeholders

Job description

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

  • Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance

  • Paid Time Off from Day One

  • 403-B Retirement Plan

  • 4 Weeks 100% Paid Parental Leave

  • Career Development

  • Whole Person Well-being Resources

  • Mental Health Resources and Support

  • Pet Benefits

Schedule:

Full time

Shift:

Day (United States of America)

Address:

2600 LUCIEN WAY

City:

MAITLAND

State:

Florida

Postal Code:

32751

Job Description:

Demonstrates advanced functional knowledge of Epic, applicable third-party solutions, and the Microsoft suite of products. Responds to inquiries from the corporate Net Revenue Accounting department to facilitate month-end net revenue calculations. Lead and mentor team while providing training, setting schedules, and evaluating performance to maintain high standards and accountability. Assesses workflow processes, identifies gaps, helps to define necessary process changes and solutions for improvement. Summarizes and reports key contract data elements to leadership and ancillary facilities, ensuring accurate patient estimation and reimbursement calculations. Maintains the digital contract database with current information, including correspondence, contract language, and rate updates, for accurate reporting to hospital and ancillary department leadership. Coordinates with payers to ensure timely execution of contract rate implementation and communicates payer policy updates, operational changes, and governmental initiatives to hospital staff and leadership. Supports and serves as a liaison between departments, payers, co-workers, Case Management, ancillaries, various hospital departments, and leadership for continued education and operational issue resolution. Chairs quarterly Joint Operation Committee meetings with key revenue cycle stakeholders, including medical directors, utilization management leaders, and health plan representatives. Extracts pertinent contract information to update the database and provides reports for distribution to senior staff. Analyzes payer data and trends to identify root cause of issues impacting AR and demonstrates ability to effectively problem solve. Effectively researches issues/topics to provide a greater level of understanding and clear communication to team and stakeholders. Contributes to projects with efficiency, accuracy, and timeliness. Supports the growth and development of the Contract Manager in the capacity of the Epic system, workflow and strategy. Other duties as assigned.

Knowledge, Skills, and Abilities:

• Microsoft Office [Required]

• Detail oriented [Required]

• Assertive [Required]

• High degree of competency in contract language interpretation [Required]

• Ability to problem solve and think analytically [Required]

• Strong organizational skills [Required]

• Effectively communicate with all department levels [Required]

• Ability to grow strong relationships [Required]

• Patient Accounting knowledge [Preferred]

• CPT/HCPCS coding knowledge [Preferred]



Education:

• Associates [Required]

• Bachelor's [Preferred]



Field of Study:



Work Experience:

• 5+ years in Managed Care, hospital revenue cycle, or payer provider relations [Required]



Additional Information:

• N/A



Licenses and Certifications:

• EPIC Credential (EPIC CRED) [Preferred]

Physical Requirements: (Please click the link below to view work requirements)
Physical Requirements - https://tinyurl.com/23km2677

Pay Range:

$60,151.66 - $111,886.39

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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