Payor Contract Manager
: Job Details :

Overview:

Catholic Health is one of Long Islands finest health and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island.

At Catholic Health, our primary focus is the way we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence based practice to improve outcomes to every patient, every time.

We are committed to caring for Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named Long Island's Top Workplace!

Job Details:

This is a hybrid role, with mandatory in office attendance at least one day per week.

Duties and Responsibilities

Primary:

• Assists System Director, Managed Care in select contract negotiations.
• Point of contact for the resolution of payer issues for assigned plans.
• Coordinate follow up activities with payers as assigned
• Collaborate with Revenue Cycle on open issues and outstanding AR.
• Serves as a liaison for hospital issues for plan policies, payment variances, participation status and performance.
• Validates rate schedules and other documents against contracts.

Position Requirements and Qualifications

Education: Bachelors degree required

Skills:

• Ability to collaborate with various internal departments as well as with payers

• Ability to accurately summarize complex claims data and effectively communicate conclusions
• Knowledge of reimbursement methodologies for Commercial, Managed Medicare and Managed Medicaid hospital contracts

Experience:

• Previous experience in a healthcare or managed care setting.
• Previous experience negotiating managed care contracts a plus
• Experience with hospital billing and or decision support systems a plus.
• Strong knowledge of the managed care environment including provider, payer, and employer.

Posted Salary Range: USD $120,000.00 - USD $130,000.00 /Yr. :

This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidates qualifications, skills, competencies and experience. The salary range or rate listed does not include any bonuses/incentive, or other forms of compensation that may be applicable to this job and it does not include the value of benefits.

At Catholic Health, we believe in a people-first approach. In addition to the estimated base pay provided, Catholic Health offers generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth.