Providence Health & Services Senior Contract Manager in Burbank, California
Providence is calling a Senior Contract Manager to Providence Health & Services Facey Mission Hills in Mission Hills, CA
We are seeking a Senior Contract Manager to be responsible for leading, or participating as a team member, in significant negotiations with Payors for acceptable reimbursement terms and contract language for all entities within the continuum of care (i.e. hospitals, physician organizations, home health and hospice services) within the applicable PH&S Region (the Region) for the payors assigned to them. Payors include the revenue primarily associated with Commercial, Medicare Advantage, and managed Medicaid products. This includes development of negotiation complex strategy and securing acceptable terms, problem resolution, and obtaining applicable support of leaders within the Service Area, Regional, System, and/or with strategic partners, such as ACO’s and Joint Ventures.
In this position you will:
Conduct complex negotiations for Providence with payors as assigned and complete contracting process in a timely manner in accordance with Providence contracting principles, organizational policies and procedures, and consistent with PH&S’s Mission.
Resolve intricate negotiation issues by using a variety of past negotiation and analytic experiences.
Manage complex and significant relationships for all assigned contracts and payor collaboration activities for both commercial and government products.
Maintain positive professional relationships with payor representatives at all times. Responsible for asking and answering questions concerning contractual agreements and resolving differences in understanding.
Develop reimbursement strategies to maintain effective payor relationships, working closely with Contract Compliance/Reimbursement Auditing, Contract Analytics, Revenue Cycle, and applicable leadership.
Be responsible for contract negotiations for Providence affiliated facilities as assigned, including acute and sub-acute facilities, Behavioral Health and Chemical Dependency facilities, Physician services, Ancillary services, Home Health Services, and Hospice.
Communicate effectively with internal constituents on reimbursement strategies, mechanisms to improve payor compliance, and to communicate status and outcomes of negotiations.
Demonstrate seasoned working knowledge of payor contracts and understanding of implications of contract changes.
Required qualifications for this position include:
Bachelor’s degree, preferably in Business Administration, Healthcare Administration, Finance, Accounting, or equivalent combination of education and/or work experience.
8 years of related healthcare experience in contract negotiations, financial management, or related field.
Deep competency and working knowledge of the payor contracting environment, including the broader marketplace.
Proficiency in computer skills and applications, including Word and Excel.
Preferred qualifications for this position include:
EPIC, MS Access and PowerPoint experience.
About the department you will serve.
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence Health & Services from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We offer a full comprehensive range of benefits - see our website for details
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Finance & Accounting
Location: California-Mission Hills
Other Location(s): California-Burbank
Req ID: 189284