What are the responsibilities and job description for the Manager, Managed Care and Payer Contracting position at Valley Health?
Who We Are
Valley Health System is a not-for-profit network of hospitals, urgent cares, physician practices, and services. Expanding across Virginia, West Virginia, and Maryland, we are devoted to the health of all who call our 18-county area home.
A vital resource for healthcare, we are the region’s largest employer, a dependable community partner, and are at the leading edge of clinical innovations.
We are looking for passionate, innovative, and caring people who will each bring their unique skills and perspectives to our workplace.
What You Will Do:
The Manager, Managed Care and Payer Contracting supports the Director in the day-to-day management, including negotiation and development of payer agreements, monitoring of payer performance and adherence to contract terms, creating and/or managing analytical tools, including contract management software, that promote an environment of effective decision-making, maintaining tools to ensure accurate modeling and payment compliance, as well as support of Patient Financial Services operations in its revenue collection mission, support of corporate customers and patients, and support of business analytics and clinical programs. The Manager, Managed Care and Payer Contracting will work closely with and support providers, executives, entity and departmental leadership, corporate teams (provider credentialing, decision support, reimbursement/tax, budgeting, and service line leaders) and other healthcare system teams to support growth opportunities and develop financial/clinical products and services to meet the specific needs of network customers, as well as in the effective and timely delivery of quality financial/information products and services to VHS customers. Must maintain a positive attitude, goal-oriented attitude, promote the messaging of the organization, and maintain a professional and courteous demeanor with all interactions with all providers, coworkers, customers, superiors, and the general public. Critical thinking skills, ability to master new concepts and software applications, high energy, and an innovative spirit are essential traits for the successful candidate.
What You Will Bring:
Education
Bachelor's degree requires
MBA, MHA, or JD Business, Finance, Healthcare, Law preferred
Experience
Working knowledge of both Managed Care and Provider Insurance Credentialing required
Working knowledge of government and non-government insurance, payer requirements, and healthcare operations required
Excellent knowledge of healthcare revenue cycle, healthcare finance, CMS and state regulations and healthcare compliance requirements/activities required
Experience in Epic preferred
Three or more years in healthcare managed care contracting experience required
Certification & Licensures
Certification in Epic Contract Manager required or obtain Epic Contract Manager Certification within one year of employment*
*In such case, Valley Health System will provide Epic Contract Manager training at VHS expense; however, a two-year stay agreement will be required.
Qualifications
Ability to maintain positive working relationships with supporting customers, staff, peers, and leadership
Ability to support multiple customers simultaneously
Working knowledge of general accounting and healthcare finance required Comprehensive understanding of healthcare revenue cycle processes, including claims payment processes
Comprehensive understanding of healthcare managed care and contracting
Working knowledge of technology alternatives applicable to healthcare contract management
Working knowledge of Microsoft Office products, including Outlook, Word, Excel, and Access
Excellent verbal and written communication skills
What You Will Get:
- Competitive salary
- Flexible scheduling
- Onsite Childcare (available at some locations)
- Health Insurance
- Paid Time Off
- Wellness Program
- Tuition Assistance
- Retirement Plan
- Life Insurance
*some benefits are subject to change due to job status
We celebrate, support, and thrive on our differences for the benefit of our employees, our patients, and the communities we serve.
We are neighbors caring for neighbors, and our goal is always to help those we serve get well, feel well, and stay well.
EOE
Criminal Background Checks
VA State Police
3rd party Background Check
FLSA Classification
Exempt
Grade
313
Physical Demands
1 A Abstractor/Analyst
Valley Health System is a not-for-profit network of hospitals, urgent cares, physician practices, and services. Expanding across Virginia, West Virginia, and Maryland, we are devoted to the health of all who call our 18-county area home.
A vital resource for healthcare, we are the region’s largest employer, a dependable community partner, and are at the leading edge of clinical innovations.
We are looking for passionate, innovative, and caring people who will each bring their unique skills and perspectives to our workplace.
What You Will Do:
The Manager, Managed Care and Payer Contracting supports the Director in the day-to-day management, including negotiation and development of payer agreements, monitoring of payer performance and adherence to contract terms, creating and/or managing analytical tools, including contract management software, that promote an environment of effective decision-making, maintaining tools to ensure accurate modeling and payment compliance, as well as support of Patient Financial Services operations in its revenue collection mission, support of corporate customers and patients, and support of business analytics and clinical programs. The Manager, Managed Care and Payer Contracting will work closely with and support providers, executives, entity and departmental leadership, corporate teams (provider credentialing, decision support, reimbursement/tax, budgeting, and service line leaders) and other healthcare system teams to support growth opportunities and develop financial/clinical products and services to meet the specific needs of network customers, as well as in the effective and timely delivery of quality financial/information products and services to VHS customers. Must maintain a positive attitude, goal-oriented attitude, promote the messaging of the organization, and maintain a professional and courteous demeanor with all interactions with all providers, coworkers, customers, superiors, and the general public. Critical thinking skills, ability to master new concepts and software applications, high energy, and an innovative spirit are essential traits for the successful candidate.
What You Will Bring:
Education
Bachelor's degree requires
MBA, MHA, or JD Business, Finance, Healthcare, Law preferred
Experience
Working knowledge of both Managed Care and Provider Insurance Credentialing required
Working knowledge of government and non-government insurance, payer requirements, and healthcare operations required
Excellent knowledge of healthcare revenue cycle, healthcare finance, CMS and state regulations and healthcare compliance requirements/activities required
Experience in Epic preferred
Three or more years in healthcare managed care contracting experience required
Certification & Licensures
Certification in Epic Contract Manager required or obtain Epic Contract Manager Certification within one year of employment*
*In such case, Valley Health System will provide Epic Contract Manager training at VHS expense; however, a two-year stay agreement will be required.
Qualifications
Ability to maintain positive working relationships with supporting customers, staff, peers, and leadership
Ability to support multiple customers simultaneously
Working knowledge of general accounting and healthcare finance required Comprehensive understanding of healthcare revenue cycle processes, including claims payment processes
Comprehensive understanding of healthcare managed care and contracting
Working knowledge of technology alternatives applicable to healthcare contract management
Working knowledge of Microsoft Office products, including Outlook, Word, Excel, and Access
Excellent verbal and written communication skills
What You Will Get:
- Competitive salary
- Flexible scheduling
- Onsite Childcare (available at some locations)
- Health Insurance
- Paid Time Off
- Wellness Program
- Tuition Assistance
- Retirement Plan
- Life Insurance
*some benefits are subject to change due to job status
We celebrate, support, and thrive on our differences for the benefit of our employees, our patients, and the communities we serve.
We are neighbors caring for neighbors, and our goal is always to help those we serve get well, feel well, and stay well.
EOE
Criminal Background Checks
VA State Police
3rd party Background Check
FLSA Classification
Exempt
Grade
313
Physical Demands
1 A Abstractor/Analyst
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