Job Summary
Manages the day to day relationships between Atrium Health and Managed Care Organizations (MCOs) within portfolio.
Essential Functions
- Supports leadership on assigned payor negotiations, including assistance with financial and operational evaluations, creating documents for review, and language review.
- Develops and maintains team-focused and cooperative internal working relationships with all revenue cycle areas of the System.
- Manages administration of the assigned portion of the contract portfolio. Understands and interprets managed care contracts and reimbursement terms which impact the revenue cycle.
- Creates and maintains electronic document database as well as original permanent files of all contract documents.
- Communicates and educates teammates regarding operational implementation of new contract terms that affect revenue cycle functions.
- Manages the implementation process for all new or re-negotiated managed care agreements.
- Serves as operations account manager for assigned MCOs.
- Serves as advisor and point of contact for all revenue cycle personnel for trended managed care operational and administrative issues.
- Understands scope of entire project, devises component tasks and assures they are completed.
Physical Requirements
Performs most work under normal office conditions which may include sitting for long periods of time, standing, walking, using repetitive wrist and arm motion or lifting articles up to twenty-five pounds.
Requires frequent verbal and written communications in English to payors, teammates, corporate team, physicians, and others throughout the System.
Education, Experience and Certifications
Bachelor's Degree or equivalent experience required; Five years total experience in managed care contracting, operations or contract administration with payer or provider;
or ten years provider PFS experience.
Five years total experience in sales with healthcare experience preferred. Experience in community relations is also a plus.
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