Payer Relations Manager - Corporate

5 - 7 years experience  •  Misc. Healthcare

Salary depends on experience
Posted on 06/27/17
Englewood, CO
5 - 7 years experience
Misc. Healthcare
Salary depends on experience
Posted on 06/27/17

Payer Relations Manager - Corporate

Healthcare Operations

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    • Posted: June 23, 2017
  • Full-Time
    • Englewood, CO, United States

Job Summary 
Responsible for developing and remediating relationships with health insurers and other payers. Creates and implements strategic and tactical plans to resolve claim payment disputes. Influences health insurers and other payers to move from a non-contracted status into a favorable contract with Air Methods (AMC). Works closely with Patient Business Services (PBS) to identify and resolve root-cause problems that lead to claim underpayments and denials. 

Essential Functions and Responsibilities include the following: 

Essential Functions and Responsibilities include the following: 
• Develops and maintains tools such as contract pipeline, contract manager, contract strategy summaries and other related payer relations tools 
• Develop strategies to minimize payer reimbursement delays and maintain or elevate payment levels 
• Provide support and input to Air Methods’ executive leadership and legal department to drive performance and assist in payer contract negotiation 
• Organize the monthly Payer Strategy Review meeting and process 
• Prepares detailed payer-specific contract strategies and contract status reports 
• Partner with the operations and leadership team as financial leader for strategy and growth 
• Participate and lead various corporate initiatives and projects 
• Other duties as assigned 
Additional Job Requirements 
• Ability to understand core business and partner with functional leads to drive operational performance metrics 
• Regular scheduled meeting attendance 
• Indicate the percentage of time spent traveling: 5% 

Additional Job Requirements 
• Ability to understand core business and partner with functional leads to drive operational performance metrics 
• Regular scheduled attendance 
• Indicate the percentage of time spent traveling 

Subject to applicable laws and Air Method’s policies, regular attendance is an essential function of the position. All employees must follow Air Methods’ employment practices and policies. 

Supervisory Responsibilities 

This position has no supervisory responsibilities. 

Qualifications 

To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. In accordance with applicable laws, Air Methods will provide reasonable accommodations that do not create an undue burden so disabled employeesmay perform the essential functions of the position. 

Education & Experience 

Bachelor’s degree (BS/BA) in Business Administration, Public Health, Healthcare Economics or related area from a four-year college or university; and five (5) to seven (7) years’ related experience and/or training. 
• MBA preferred, or equivalent combination of education and experience. 
• Knowledge of healthcare services and/or health insurance preferred 
• Previous consulting experience preferred (internal or external) 
• Experience with payer negotiation either process, payment level or both. 
• Experience reading and interpreting payers’ policy plan documents and billing policies. 

Skills 

• Demonstrates high critical thinking and reasoning skills and strong attention to detail while working in a fast paced environment that requires ability to prioritize and multi-task 
• Ability to analyze and resolve complex problems and negotiate contracts with broad direction. Identifies opportunities toutilize advance interpersonal skills to resolve intricate payment disputes . Actively seeks the input and opinions of stakeholders and explores a wide range of options before acting 
• Ability to develop and present recommendations from accurate assessments and/or analysis. Offers solutions and designs to solve process, project or program issues. Defends a recommendation and can confidently support it 
• Ability to tackle ambiguous situations and develop solutions with minimal supervision 
• Ability to be a team player with a professional attitude 
• Strong business acumen with the ability to understand business situations, strategies, theory, processes, management, budgeting and operations 

Computer Skills 

Advanced Microsoft Office Suite, including Excel, Word, PowerPoint and Outlook

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