Contract/Provider Service Manager, Sr

Emory Healthcare•Tucker, GA

10h

About The Position

At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. This role independently assesses, analyzes, and negotiates payer contracts for all hospital and professional entities within Emory Healthcare (EHC). It involves managing information for loading and maintaining payer contracts in EHC decision support systems, and implementing new contracts, amendments, and business process modifications. The manager also handles provider service relationships for assigned payer organizations and EHC provider entities, focusing on contract interpretation for operational issues and problem resolution. A key aspect is determining and managing revenue enhancement opportunities through enhanced contract management, balancing contract negotiations with provider service interests.

Requirements

Bachelor's degree required.
Four years experience required, but prefer seven years of healthcare related experience, preferably in a complex Provider or Payer managed care organization.
Demonstrates innovative and critical thinking with creative approaches to problem solving.

Nice To Haves

Master's degree preferred.
Prefer seven years of healthcare related experience, preferably in a complex Provider or Payer managed care organization.

Responsibilities

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.