Manager of Payor Contracting
- Job Title
- Manager of Payor Contracting
- Job ID
- 27695833
- Location
- Nashville, TN 37205
- Other Location
- Description
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Job Purpose:
Manager of Payor Contracting is responsible for reviewing, auditing and negotiating existing and new Payor contracts with Health Insurance companies (ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care, the Manager of Contracting is responsible for managing legal review, policy compliance, contract retention and administrative tracking of all various managed care payors. Advances company payor strategy and aligns negotiation with strategy.
Essential Functions:- In collaboration with the Director of Managed Care, negotiate and manage assigned contracts, including initiate, plan, finalize, implement, report (written and verbal) and direct related negotiations.
- Proposes contracting and pricing models and strategies using knowledge of market, local and national benchmarks, and payer market. Key member of negotiating team for company.
- Negotiates contract language across all contracts, striving for uniformity among different contracts, partnering with the General Counsel as needed and as appropriate.
- Coordinates finance, legal and operational reviews of contracts. Coordinates sign off on all proposed terms of contracts and amendments, adhering to Company contract sign off and approval processes.
- Adheres to all Company processes for tracking rates and terms of all contracts.
- Is a valuable member of the team based on core business subject matter expertise, general industry knowledge and skills and interest in being a member of a team. Consults with other members of the Leadership Team on contract terms and updates to contracts that may apply to operational areas.
- Has the authority to direct and support managers with functional area responsibilities.
- Bachelor's degree required. Master's degree preferred.
- 5-8 years related work experience required in Revenue cycle including Payor contracts and 1-3 years supervisory/management experience required
- Negotiation and Presentation Skills.
- Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases.
Strong Business and Organizational Competence. Exceptional Customer Service Skills. Strong functional Competence. Interpersonal Skill Competency. Stress Tolerance. Initiative. Adaptability. Accountability. Integrity. Self-Confidence. Time Management Skills with an emphasis on multi-tasking.
Physical Demands and work environment
The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Physical demands: Required job duties are essentially sedentary in nature, consisting of occasional walking, standing, lifting and/or carrying ten pounds maximum, seeing, speaking and hearing.
Work environment: Required job duties are normally performed in a climate-controlled office environment.
