Overview
VP, Managed Care Services/Hospital Contracting Jobs in United States at Axion Staffing
Title: VP, Managed Care Services/Hospital Contracting
Company: Axion Staffing
Location: United States
Job Purpose
The successful candidate will lead all aspects of managed care for End to End Revenue Cycle customers. The successful candidate will be responsible for negotiating managed care contracts and single case agreements and provide all areas of managed care support including reviewing pricing for accuracy, optimizing revenue and reviewing payer performance. The candidate must have a deep understanding of healthcare reimbursement trends, exceptional ability to negotiate favorable contracts with payers, and possess excellent client relationship skills. The candidate must also have a thorough understanding of the revenue cycle including third party payer requirements. Minimum requirements include ten years or more of relevant experience in a hospital or healthcare managed care department setting and prior management experience.
Duties and Responsibilities
**Position will require 2-3 days per month on-site at a NY Hospital
**NY Contracting Experience REQUIRED
Responsible for the oversight, negotiation and strategic direction of managed care contracts for all end-to-end revenue cycle customers.
Develop processes to manage the implementation of completed contracts and ongoing management including tracking of critical contract renewal dates, ensuring proper loading of managed care contracts into contract management system and overseeing the dissemination and communication of contract information to internal stakeholders.
Monitor contract performance regarding financial performance, payment integrity and compliance with contract terms and key performance indicators.
Oversee payer relationships.
Collaborate with payment variance and accounts receivable services departments to analyze payer behavior and lead JOC meetings to address.
Provide assistance/resolution to external and internal client inquiries.
Act as a technical expert in regard to financial class responsibility, to answer questions raised by clients and team members.
Maintain a current working knowledge of all healthcare related issues and regulations, especially Managed Care contracts.
Maintain confidentiality at all times.
Learn and comply with organizational and departmental policies and procedures
Analyze and solve problems quickly and thoroughly.
Establish realistic goals and priorities concurrent with organizational objectives.
Knowledge of governmental, legal and regulatory provisions related to collection activity.
Knowledge of insurance company practices regarding reimbursement.
Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
Qualifications
10 yrs. minimum experience of managed care contracting within a health system or large medical group and reimbursement analysis in either a provider or payer setting.
Extensive knowledge, experience and expertise in managed care contracting negotiations, language, modeling analytics, reimbursement methodologies for hospitals, shared savings and risk contracting, managed care regulations and quality/shared savings program metrics and methodologies.
Excellent written and verbal communication skills.
Demonstrated skills in attention to detail, superior project management, analytical ability as well as the ability to coordinate and lead activities using a collaborative team approach.
Ability to handle multiple projects and perform independently under tight deadlines with a focus on effective implementation, clear communication and follow-up.
Ability to work well individually and in a team environment.
Able to work in a professional, corporate setting.
Must be reliable, responsible, goal oriented and flexible.
Professional telephone skills.
Excellent interpersonal communication and organizational skills.
Prior Management experience.
