DE - Contracting and Payer Relations Executive Director - Dover
DE - Contracting and Payer Relations Executive Director - Dover
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Job Description
Mobile Health Team Inc. a staffing agency has an opening for a permanent fulltime Executive Director Contracting & Payer Relations position. We are looking for someone with a passion for people.
Location: Dover DE 19901
Start Date: 10/3/2024
Shift: Days Full Time 80 Hours biweekly
Salary: $140000.00 to $225000.00
Benefits:
- Paid Time Off and Paid Holidays
- Matching 401(k)/403(b) Plans
- Excellent Health Dental Vision Disability and Life Insurance options
Looking for a Contracting & Payer Relations Executive Director who is engaged in their profession committed to providing the best service and believes in the mission. We are looking for staff with Compassion Accountability Respect Integrity and Teamwork.
Reporting to the CFO the Executive Director of Contracting & Payer Relations is responsible for all aspects of managed care governmental valuebased and population health/clinical integration for the medical center and group. The position is charged with developing and improving relationships with thirdparty payers. As a key member of the Revenue Cycle team the senior director ensures reimbursement rates are as robust as possible and that thirdparty payers are abiding by the contract terms. The Executive Director works collaboratively with the other Revenue Cycle leaders and key stakeholders to make certain that everyone is aware of and strives to correct issues or disagreements arising with payers.
RESPONSIBILITIES
- Negotiates agreements with thirdparty payers to achieve operating terms and reimbursement rates that will support the medical centers strategic goals.
- Generates reports that describe the successes and opportunities in the revenue cycle.
- Meets with the leadership of Delawarebased plans to discuss strategic plans and opportunities for improvement and collaboration.
- Recommends managed care contracting strategy to CFO.
- Serves as the primary source of communication and liaison with thirdparty payers.
- Fosters effective collaboration between departments to ensure a consistent and integrated approach in daily operations to managed care requirements.
- Collaborates with the Denials Department to create effective appeals.
- Conducts regularly scheduled meetings with thirdparty payers to improve payment processes and followup on claims due and other outstanding issues.
- Represents the medical center in statewide meetings and participates with regional associations.
- Accountable for the overall success of Bayhealths managed care strategy.
- Maintains the EPIC contract management system.
- Ensures that annual payment adjustments are accurate and complete.
- Creates Price Transparency machinereadable files each year.
- Serves on utilization review level of care and readmission committees.
- Negotiates singlecase agreements as required.
- Provides input on charge master development and adjustments.
- All other duties as assigned within the scope and range of job responsibilities.
EXPERIENCE/EDUCATION/QUALIFICATION
Experience:
- A minimum of 10 years of contract negotiation with Managed Care Organizations is required
Education:
- A Masters Degree in Business Administration is required
- Masters Degree in Health Administration or Related field
Licenses Certifications and Registration:
- Certification related to the position if applicable.
M277938
Mobile Health Team Inc is a workforce solutions company. We match experienced healthcare professionals with temporary or permanent positions globally. Our mission is clear to bridge the staffing gap in the healthcare industry by creating and maintaining longterm working relationships with clients and healthcare professionals. We specialize in temporary and permanent placements in order to meet our clients needs.
Employment Type
Full Time
