Payor Relations Manager

Iowa, IA - USA

Monthly Salary: Not Disclosed

Posted on: 30+ days ago

Vacancies: 1 Vacancy

Job Summary

UI Health Cares Finance and Accounting Services Department is seeking a Payor Relations Manager. The Manager is responsible for contributing to the achievement of Payor Relations/Revenue Management financial targets by 1) negotiating implementing and maintaining new and existing fee-for-service and value-based payor contracts with third party payors and the Veterans Administration 2) developing and utilizing financial and data management tools for evaluating and monitoring the performance of managed care contracts 3) providing knowledge support to internal operational units about contractual relationships 4) participating in the development of Payor Relations strategies on behalf of the University of Iowa Health Care including but not limited to Medical Center University Medical Center Downtown Medical Center North Liberty Mission Cancer Blood and the Carver College of Medicine University of Iowa Physicians (UIP).

Position Responsibilities:

Negotiates develops implements and maintains commercial payor contracts on behalf of UI Health Care for first tier (revenues >$10 million) second tier (revenues <$10 million) contract values and individual patient case agreements involving direction review interpretation and validation of financial analyses for facility professional and specialty pharmacy services.

Provides operational guidance and/or reimbursement analysis direction to Financial and Business Analysts in UI Health Care Finance Revenue and Reimbursement Decision Support Population Health and Pharmacy and to Revenue Cycle staff in Patient Financial Services relating to EPIC and Strata setup/troubleshooting payor reimbursement and coverage policies and contracting areas such as Workers Compensation and employer group Profit/Loss reporting mechanisms.

Identifies and recommends appropriate changes in operations that might be required to accommodate payor contracts.

Prepares and communicates contract language negotiation documentation for third party payor and specialty pharmacy agreements researching and tracking requested and accepted changes and recording background on specific language issues.

Prepares periodic management reports and analyses summarizing the financial impact of rate proposals for third party payor contracts for review by Payor Relations team UI Health Care Finance leadership and internal stakeholder review when applicable.

Monitors interprets and reports on changes in performance market trends and payor policies and operations which have potential impacts on revenue clinical operations and billing operations. Provides recommendations to Payor Relations and UI Health Care Finance leadership regarding trends issues and opportunities for revenue growth.

Required qualifications

Bachelor s degree in Business Administration or related field or an equivalent combination of education and experience.

3-5 years of related experience in payor relations managed care contracting health care revenue cycle billing and operations or health care administration.

Demonstrated proficiency with all Microsoft Office products.

Reasonable knowledge of complex financial and statistical analysis and presentation.

Excellent critical analysis and business reporting skills.

Excellent written and verbal communication skills.

Ability to multitask and work in a fast-paced environment.

Demonstrated experience working effectively in a welcoming and respectful workplace environment.

Desired qualifications

Masters degree in a related field

5 years of related experience in payor relations managed care contracting health care revenue cycle billing and operations or health care administration.

Experience with complex payor contract analysis modeling monitoring and compliance using tools such as Epic Strata and Power BI.

Knowledge of population health and value-based care concepts.

Knowledge of University of Iowa and UI Health Care policies and procedures.

Application Process:To be considered applicants must uploada cover letter and resume(under the submission of relevant materials)that clearly address how they meet the listed required and desired qualifications of this position. Job openings are posted for a minimum of7calendar days. Successful candidates will be required to self-disclose any conviction history and will be subject to a criminal background check and credential/education verification.

Up to 5 professional references will be requested at a later step in the recruitment process. For questions contact Sharon Walther at.

This position is not eligible for University sponsorship for employment authorization now or in the future.

Additional Information

Compensation

Contact Information

Required Experience:

Manager

UI Health Cares Finance and Accounting Services Department is seeking a Payor Relations Manager. The Manager is responsible for contributing to the achievement of Payor Relations/Revenue Management financial targets by 1) negotiating implementing and maintaining new and existing fee-for-service and ...