Contract/Provider Service Manager, Sr- Transplant
About The Position
Independently assesses, analyzes, and negotiates payer contracts for all hospital and professional entities within Emory Healthcare (EHC). Manages information for loading and maintaining payer contracts in EHC decision support systems. Implements new contracts, amendments, and business process modifications. Manages provider service relationships for assigned payer organizations and assigned EHC provider entities, by managing contract interpretation for operational issues and problem resolution. Determines and manages revenue enhancement opportunities for EHC entities through enhanced contract management. Manages the balance of contract negotiations and provider service interests through dual responsibility. Performs other related duties as required.
Requirements
- Bachelor's degree required.
- Four years experience required.
- Demonstrates innovative and critical thinking with creative approaches to problem solving.
- Managed Care Contracting Experience
- Transplant Experience
- Contract Negotiation Experience
- Academic Medical Center Experience
- Solid Organs/ Stem Cell Specialty Experience
- Resolving Problems with Payers
- Medicare Understanding
- Payer/Hospital Experience
Nice To Haves
- Master's degree preferred.
- Seven years of healthcare related experience, preferably in a complex Provider or Payer managed care organization.
- Transplant experience
Responsibilities
- Assesses, analyzes, and negotiates payer contracts for all hospital and professional entities within Emory Healthcare (EHC).
- Manages information for loading and maintaining payer contracts in EHC decision support systems.
- Implements new contracts, amendments, and business process modifications.
- Manages provider service relationships for assigned payer organizations and assigned EHC provider entities, by managing contract interpretation for operational issues and problem resolution.
- Determines and manages revenue enhancement opportunities for EHC entities through enhanced contract management.
- Manages the balance of contract negotiations and provider service interests through dual responsibility.
- Performs other related duties as required.
Benefits
- Comprehensive health benefits that start day 1
- Student Loan Repayment Assistance & Reimbursement Programs
- Family-focused benefits
- Wellness incentives
- Ongoing mentorship, development, leadership programs
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What This Job Offers
Job Type
Full-time
Career Level
Senior
