Full Job Description
The Payor Relations Manager provides leadership in protecting the reimbursement of Aspirus in management of payor relationships, maintaining the integrity of payor and contract information, and ensuring timely enrollment of providers with payors. This position is critical to the advancement of Aspirus' thorough understanding of payors and our relationship with them so that processes can adjust as this portion of healthcare changes. In this position, the Payor Relations Manager oversees teams that focus on ensuring payor contracts are understood, appropriate payments are received from payors, underpayments are appealed, and ensures Aspirus facilities and providers are timely and accurately enrolled with contracted payors. This position is responsible to build constructive relationships with Aspirus payors through regular meetings, review of performance metrics, and the resolution of elevated issues within Aspirus through collaborating with Aspirus Network or working directly with the payor. The Payor Relations Manager also provides education to Aspirus on new payors and plans to ensure proper identification and handling for our Aspirus patients. The Payor Relations Manager facilitates and plays a key role in governance and steering committees over the areas of responsibility.
HOURS: Full Time, 1.0 FTE, 80 hours every two weeks
Experience/Qualifications
3 Knowledge of healthcare financial management or related field normally acquired through completion of a Bachelor's Degree in Business, Finance, Accounting, or other health related profession.
3 Three to five years of experience supporting a managed care or payor relations functions at either health plan or provider organizations.
3 Knowledge of contract language provisions and payor relations-oriented issue resolution.
3 Experience preparing and working with financial analysis of high complexity.
3 Supervisory or management experience necessary to develop administrative skills, including work experience in project management is preferred.
3 Previous experience with auditing and internal controls is preferred.
3 Working knowledge of current Medicare, Medicaid, and other regulatory or payor guidelines and requirements.
3 Possesses a high level of resourcefulness, innovation, and interpersonal and critical thinking skills.
3 Ability to use independent judgment and decision-making.
3 Ability to deal with frequent interruptions.
3 Ability to prioritize workload.
3 Ability to collaborate including building, leading, motivating and coordinate activities of a cross-functional and/or multi-corporate team.
3 Possesses project management and implementation skills necessary to develop and implement appropriate changes impacting revenue and reimbursement.
3 Strong personnel management skills to direct work of and motivate assigned staff.
3 Excellent verbal and written communication skills including the ability to communicate technical/regulatory concepts to a non-technical audience.
3 Detailed knowledge of revenue cycle functions and revenue flow.
3 Understanding of Industry specific terminology.
3 Position requires some travel.
3 Strong troubleshooting skills.
3 Possess conflict resolution skills.
3 Strong customer orientation.
3 Professionalism.
3 Annual competencies as required by Aspirus and/or various regulatory agencies based on entity and/or job position.
Employee Benefits
3 Full benefits packages available for part- and full-time status.
3 Time away from work accrual.
3 Retirement plans available.
3 Wellness program for employees and their families.