Milk and Formula Coordinator-Full Time
About The Position
The Managed Care Contracting Team within MSHP is responsible for the negotiation, implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP’s subject matter experts on: Facility related Agreements and Amendments, financial performance for all contracts, and facility, ancillary related contract negotiations. The Managed Care Team is at the forefront of implementing Facility and Ancillary Contracts across the Mount Sinai Health System. MSHP seeks a Senior Contract Manager Analyst will play a critical role in testing, coding, modeling, and reporting on Hospital Billing (HB) and Professional Billing (PB) contracts for the MSHS Health System. This individual will ensure the accuracy of contract terms, reimbursement structures, and facilitate the flow of contract data into the revenue cycle system. A strong background in contract coding, logic, and the ability to interpret contract terms and reimbursement guidelines is essential. Revenue cycle experience is highly desirable.
Requirements
- Must have an Associate's Degree or equivalent.
- Completion of required training and competency for formula and breast/donor milk preparation expected within 60 days of hire.
Nice To Haves
- Bachelor's Degree and/or higher academic standing preferred.
- Work experience, preferred; nutrition or food service experience a plus.
- Preferred previous nutrition education or experience working in a medical laboratory.
- Previous experience working in a milk or formula room, preferred
- Infant feeding technician certification, preferred.
Responsibilities
- Contract Testing & Validation: Conduct thorough testing of contract logic to ensure proper contract terms, rates, and reimbursement schedules are applied. Validate accuracy of system configurations for new and updated contracts.
- Coding & Modeling: Apply contract coding techniques to accurately map and model contracts within the healthcare system. Develop and maintain models that reflect reimbursement terms and other financial obligations outlined in contracts.
- Reporting & Analysis: Generate and analyze reports on contract performance, identifying discrepancies or issues impacting revenue. Provide actionable insights on contract-related data to enhance decision-making and optimize reimbursement.
- Contract Review & Interpretation: Analyze and interpret contract terms, conditions, and reimbursement guidelines to ensure alignment with financial goals. Work with legal, financial, and clinical departments to resolve discrepancies or ambiguities in contract language.
- Collaboration & Support: Collaborate with the Revenue Cycle team to integrate contract terms into billing, claims, and payment systems. Provide support and guidance to internal teams on complex contract issues and changes in reimbursement methodologies.
- Continuous Improvement: Identify and recommend process improvements related to contract administration, coding, and reporting. Assist in the development of best practices and standard operating procedures for contract management and coding.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
