5-7 years of experience in healthcare, especially with managed care
Bachelor's degree required, Master's preferred
Experience in managed care contracting and negotiations
Knowledge of transplant and solid organs/stem cell specialties
Ability to resolve issues with payers
Strong understanding of Medicare
Experience in academic medical settings
Responsibilities
Assess and negotiate payer contracts for all healthcare entities
Manage and update payer contract data in decision support systems
Implement contracts, amendments, and process changes
Maintain provider service relationships with assigned payers
Identify revenue enhancement opportunities through effective contract management
Balance negotiation interests with provider service needs
Handle additional related duties as needed
Benefits
Comprehensive healthcare coverage
Retirement savings plans
Professional development opportunities
Flexible work environment
Supportive team culture
Full Job Description
Preferred candidates need to have transplant experience as well as the following:
Managed Care Contracting Experience
Transplant Experience
Contract Negotiation Experience
Academic Medical Center Experience
Solid Organs/ Stem Cell Specialty Experience
Resolving Problems with Payers
Medicare Understanding
Payer/Hospital Experience
Description
OVERVIEW:
Independently assesses, analyzes, and negotiates payer contracts for all hospital and professional entities within Emory Healthcare (EHC).
Manages information for loading and maintaining payer contracts in EHC decision support systems.
Implements new contracts, amendments, and business process modifications.
Manages provider service relationships for assigned payer organizations and assigned EHC provider entities, by managing contract interpretation for operational issues and problem resolution.
Determines and manages revenue enhancement opportunities for EHC entities through enhanced contract management.
Manages the balance of contract negotiations and provider service interests through dual responsibility.
Four years experience required, but prefer seven years of healthcare related experience, preferably in a complex Provider or Payer managed care organization.
Demonstrates innovative and critical thinking with creative approaches to problem solving. PHYSICAL REQUIREMENTS (MediumMax 25lbs): up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks. ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.
