Location
Remote, US


Scheduled Hours
40
Position Summary
Position is responsible for the following critical functions: Managed Care pricing and rate contracting strategy, Transplant Contracting Data Collection, Managed Care fee schedule management – commercial and government payers, Managed Care Analysis and Reporting. In the performance of the noted functions this position will be expected work closely with the representatives of various managed care organizations, WUSM faculty, WUSM Department Business Managers, various WUSM staff and BJC Managed Care Contracting.
Job Description
Primary Duties & Responsibilities:
- Develops fee schedule proposals as well as counter proposals to assist in the negotiation and implementation of all reimbursement related contract terms.
- Maintains fee schedule data for all commercial and government payers.
- Responsible for both managed care and transplant fee schedule integrity. Ensures that all fee schedules are appropriately updated and communicates changes to WashU Departments, Physician Billing Service (PBS) and other appropriate parties.
- Develops schedules and strategies to maximize the annual updates to fee schedules that represent $300,000,000 in annual revenue.
- Identifies contracting opportunities to enhance net revenues and actively advises Departments.
- Monitors, understands and articulates industry and government trends which impact managed care pricing –including but not limited to: CPT-4, HCPCS level II, revenue coding.
- Interprets managed care contracts and assist Department leadership as well as PBS Revenue Integrity/MPV team in resolving reimbursement disputes with payers.
- Maintains transplant contracting database.
- Fosters teamwork, innovative thinking and knowledge sharing with Departments, PBS and Contracting to enhance contract integration.
- Responsible for providing or coordinating high level analysis and reporting support to PBS and the Faculty Practice Plan (FPP).
Working Conditions:
Job Location/Working Conditions:
- Normal office environment.
Physical Effort:
- Typically sitting at desk or table.
- Repetitive wrist, hand or finger movement.
Equipment:
The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all job duties performed by the personnel so classified. Management reserves the right to revise or amend duties at any time.
Required Qualifications
Education:
Bachelor’s degree or combination of education and/or experience may substitute for minimum education.
Certifications/Professional Licenses:
No specific certification/professional license is required for this position.
Work Experience:
No specific work experience is required for this position.
Skills:
Not Applicable
Driver's License:
A driver's license is not required for this position.
More About This Job
WashU seeks highly motivated individuals who are able to perform duties in a manner consistent with our core mission and guiding principles.
Preferred Qualifications
Education:
No additional education unless stated elsewhere in the job posting.
Certifications/Professional Licenses:
No additional certification/professional licenses unless stated elsewhere in the job posting.
Work Experience:
No additional work experience unless stated elsewhere in the job posting.
Skills:
Analytical Thinking, Computer Literacy, Detail-Oriented, Epic EHR, Health Administration, Health Care Systems, Interpersonal Communication, Managed Care Operations, Microsoft Access, Microsoft Excel, Oral Communications, Self-Direction, Statistics, Written Communication
Grade
G13
Salary Range
$65,900.00 - $112,700.00 / Annually
The salary range reflects base salaries paid for positions in a given job grade across the University. Individual rates within the range will be determined by factors including one's qualifications and performance, equity with others in the department, market rates for positions within the same grade and department budget.
Questions
For frequently asked questions about the application process, please refer to our External Applicant FAQ.
Accommodation
If you are unable to use our online application system and would like an accommodation, please email CandidateQuestions@wustl.edu or call the dedicated accommodation inquiry number at 314-935-1149 and leave a voicemail with the nature of your request.
All qualified individuals must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship.
Pre-Employment Screening
All external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. All offers are contingent upon successful completion of required screening.
Benefits Statement
Personal
Up to 22 days of vacation, 10 recognized holidays, and sick time.
Competitive health insurance packages with priority appointments and lower copays/coinsurance.
Take advantage of our free Metro transit U-Pass for eligible employees.
WashU provides eligible employees with a defined contribution (403(b)) Retirement Savings Plan, which combines employee contributions and university contributions starting at 7%.
Wellness
Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more!
Family
We offer 4 weeks of caregiver leave to bond with your new child. Family care resources are also available for your continued childcare needs. Need adult care? We’ve got you covered.
WashU covers the cost of tuition for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us.
For policies, detailed benefits, and eligibility, please visit: https://hr.wustl.edu/benefits/
EEO Statement
Washington University in St. Louis is committed to the principles and practices of equal employment opportunity. It is the University’s policy to provide equal opportunity and access to persons in all job titles without regard to race, ethnicity, color, national origin, citizenship (where prohibited by federal law), age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information.
