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Morristown/NJ/USANEW! NEW!Loading... Please wait.Expand Show Other JobsJob Saved Save JobManager, Payor Relations and Contract ManagementChristianaCare Health SystemApplicationDetails
Location: Wilmington, Delaware
Internal Number: JR66870
At ChristianaCare, we serve as our neighbors as respectful, expert, caring partners in their health. We do this by creating innovative, effective, affordable systems of care that our neighbors value. Are you an authority regarding contract negotiation, implementation, compliance, and managing payer relationships? If you possess this desire and a background in payer and provider based reimbursement this is the opportunity you have been seeking!
Incredible Work/Life benefits including annual membership to care.com, access to backup care services for dependents through Care@Work, retirement planning services, financial coaching, fitness and wellness reimbursement, and phenomenal discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets, etc.
We also provide tuition assistance for degreed programs. Our medical/dental/vision benefits are available to our caregivers on their first day of employment! And we offer two different mechanisms toward planning for your retirement, a 403(b) and a defined contribution plan.
As the leader of our Managed Care Contracting team you be responsible for providing contracting services, support and representation to managed care payors for all enterprise-wide entities,
The successful candidate is responsible for:
- Lead negotiations for designated contracts including but not limited to Dental, Vision, Skilled Nursing, Transplant, Direct to Employer contracts within the managed care contract portfolio
- Provide support to the negotiating team by evaluating draft contracts in compliance with company templates, reimbursement structure standards, and internal operational and clinical structures
- Collaborate with finance to develop and maintain each respective organization's financial contracting modeling system by ensuring contract rates are loaded and results are validated to enable the development and evaluation of various facility reimbursement models within the markets of DE, MD, PA, and NJ
- Collaborates with stakeholders across the organization including but not limited to; finance, legal, population health, clinical operations, etc.
Education and experience requirements:
- Bachelor's degree strongly preferred in Finance, Economics, Healthcare or Business related
- Minimum of six (6) years of provider-based reimbursement/contracting experience and/or payer-based reimbursement/contracting/payer relations experience through managed care reimbursement review/management, consulting, or population health management is required
- Understanding of provider contracting, payer policies and procedures and various reimbursement methodologies is required
- Proven track record of experience with Hospital, physician, ancillary, bundle payment and other revenue cycle types of reimbursement
ChristianaCare is one of the country's most multidimensional health systems, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs. Christiana Care includes an extensive network of outpatient services, home health care, medical aid units, three hospitals (1,300 beds), a Level I trauma center and regional centers of excellence in heart and vascular care, cancer care and women's health.
Working for Christiana Care offers the best of urban and suburban living with multiple housing options, excellent restaurants and entertainment venues, quality schools and a short driving distance to popular Delaware and New Jersey beaches. The location provides easy access to Washington, DC, Philadelphia and New York City - all within a short drive or train ride from Newark, DE.About ChristianaCare Health SystemChristianaCare Health System is headquartered in Wilmington, Delaware and is one of the country's largest health care providers, ranking 21st in the nation for hospital admissions. Christiana Care is proudly a Nurse Magnet recognized institution. Christiana Care Health System is also one of the largest health care providers in the mid-Atlantic region, serving all of Delaware and portions of seven counties bordering the state in Pennsylvania, Maryland and New Jersey. A not-for-profit, non-sectarian health system, Christiana Care includes two hospitals with more than 1,100 patient beds, and is a major teaching hospital with two campuses. Christiana Care is continually recognized for excellence on a regional and national level. Our role in the community is expressed in the Christiana Care Way: "We serve our neighbors as respectful, expert, caring partners in their health. We do this by creating innovative, effective, affordable systems of care that our neighbors value."Christiana Care is a great place to work because we value diversity and recognize it to be a core part of our success. Because of the diversity of our employees, affiliated health professionals and volunteers, we are ...positioned to meet the unique needs of our patients and community. We acknowledge and celebrate the uniqueness and talent of each employee. Because of our talented workforce we are able to provide a quality healthcare experience to our patients and community. We strive to create an inclusive environment in which individual diversity can be leveraged and thrive. Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.Show moreShow lessMore Jobs from This Employerhttps://careers.qualityforum.org/jobs/18225405/manager-payor-relations-and-contract-managementLoading. Please wait.