Manager of Payer Relations

Ascension

10d•Remote

About The Position

Oversees payer relationships, Joint Operating Committees, operational and utilization management meetings, and facilitates communication with payers. Manage and coordinate functions and/or resources associated with organizing, implementing and meeting goals/guidelines. Engage and manage escalations of payer issues. Participate in development and oversight of payer performance reporting and scorecards. Coordinate and manage relevant payer meetings to facilitate relationships and resolution of issues. Research and escalate emerging payer issues and drive problem resolution. Act as a liaison to resolve complex issues and payment challenges. Stay current on payer policies, regulatory changes, and reimbursement trends, and identify concerns for escalation process. Develop scorecards and reports to monitor payer performance. Participate with leadership teams to provide clarity to the scope of work. Communicate status of operations to management and associates. Develop presentation materials various levels of management discussions and payer meetings Prepare and analyze departmental financial reports, financial analysis and budgetary reports.

Requirements

High School diploma equivalency with 3 years of cumulative experience OR Associate's degree/Bachelor's degree with 2 years of cumulative experience OR 7 years of applicable cumulative job specific experience required.

Nice To Haves

3 years of leadership or management experience preferred.

Responsibilities

Oversees payer relationships, Joint Operating Committees, operational and utilization management meetings, and facilitates communication with payers.
Manage and coordinate functions and/or resources associated with organizing, implementing and meeting goals/guidelines.
Engage and manage escalations of payer issues.
Participate in development and oversight of payer performance reporting and scorecards.
Coordinate and manage relevant payer meetings to facilitate relationships and resolution of issues.
Research and escalate emerging payer issues and drive problem resolution.
Act as a liaison to resolve complex issues and payment challenges.
Stay current on payer policies, regulatory changes, and reimbursement trends, and identify concerns for escalation process.
Develop scorecards and reports to monitor payer performance.
Participate with leadership teams to provide clarity to the scope of work.
Communicate status of operations to management and associates.
Develop presentation materials various levels of management discussions and payer meetings
Prepare and analyze departmental financial reports, financial analysis and budgetary reports.