Contracting and Payor Relations Administrator I

Johns Hopkins Healthcare   •  

Glen Burnie, MD

Industry: Healthcare

  •  

8 - 10 years

Posted 67 days ago

This job is no longer available.

The Contracting and Payer Relations Administrator reports to the Director of Bundled Rate Contracting and ensures compliance with the administration of managed care contracts and ensuring compliance with payer policies and procedures. This individual serves as a resource for staff at all JHM Operational Units and Senior Management levels as well as front line staff regarding Managed Care Contracts. Position provides contract surveillance, maintenance of Managed Care Reference Materials and the Managed Care website.

Requirements:

  • A Bachelor’s Degree in Healthcare Administration or related field is required; A Master’s Degree in related field is preferred - Some work experience may be substituted for educational requirement
  • A minimum of 7 years’ experience in a health care environment or human services with a minimum of 3 of those years working on insurance issues with emphasis on clinical operations, contract management, financial counseling or training
  • Knowledge of managed care and health care concepts and terminology as well as knowledge of the health care industry
  • Ability to interpret health care policies
  • Knowledge of health care contract administration to include the relationship among operational units involved in executing and maintaining contracts
  • Understanding of hospital and physician billing system and practices
  • Excellent verbal and written communication skills to effectively interact with Johns Hopkins employees at all levels, (physicians, nurses, clinic mangers and office staff), plan representatives as well as plan beneficiaries and other external business related associates
  • Strong independent research skills
  • Analytical and decision-making skills to solve complex problems
  • Advanced project management skills to prioritize multiple initiatives and assigned tasks

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