Payor Contracts Manager - RT
Vancouver, Washington 98663
Responsible for the analysis, negotiation, monitoring and administrative oversight for a wide variety of complex third party payor contracts. Provides ongoing maintenance of contracts to ensure compliance.
Required Knowledge, Skills, and Abilities: (Submission Summary)
1. BA degree in Healthcare or Business required or a combination of education and experience that provides the caregiver with the requisite knowledge, skills and abilities to perform the job.
2. A Master’s degree in Supply Chain Management, MBA or MSN is preferred.
3. Five years progressive experience in an applicable area of the healthcare industry such as business development, legal contract department, provider relations, patient financial services, financial analysis.
4. Prefer direct experience in contract negotiations and analysis for a third party payor or healthcare delivery system.
5. Knowledge of traditional fee-for-service contracts and reimbursement methodologies for both hospital and professional services.
6. Computer experience and working knowledge of MS Word and Excel required. Knowledge of Access, PowerPoint, DataMart, and ProClarity desired.
7. Strong analytical, organizational and problem-solving skills.
8. Proven ability to conceptualize issues and develop pragmatic solutions.
9. Demonstrated ability to work independently and able to manage and prioritize large projects while focusing on details.
10. Knowledge of standard health insurer policies, benefit design, ICD-10, CPT, DRG coding requirements, case rates, DRG-based payment, as well as population focused contracts (pmpm, risk pools and funding approaches, financial and clinical services quality incentives, bundled payments, etc..
11. Knowledge and understanding of private and public healthcare financing, reimbursement protocol and government regulations related to healthcare services.
12. Excellent verbal and written communication skills. Must be able to articulate complex business issues.
13. Must be able to retrieve computer data, receive and process a large quantity of detailed, complex verbal and written information quickly.
14. Present Salary?
15. Salary Expectation?
16. Must be a US Citizen or Green Card holder?
17. Current Address?