3 Payor Contract Manager Full Time Jobs in Columbus, GA
Hughston is Hiring a Payor Contract Manager Full Time Near Columbus, GA
Position Responsibilities
- Manage professional service healthcare network participation and negotiate and maintain competitive contracts with all targeted healthcare insurance payors. This includes researching territories to maintain a balanced payor mix, addressing gaps with our payor base and supporting expansion into new markets.
- Maintain proactive relationships with payors and develop new relationships as required to support Hughston’s strategic objectives. Ensure contractual language is kept current; evaluate fee schedule on a yearly basis to identify possible opportunities for additional covered services, strategic partnerships, medical policy changes and reimbursement updates.
- Facilitate the review and approval process of all contract documents from pre-contract through post signature phases, accuracy of supporting documentation, and timely maintenance in systems.
- Develop and maintain processes that provide timely notification and administration of critical contract events (e.g., any annual rate updates, contract renewals, termination, proper notices, and other critical contract requirements).
- Establish influential relationships with practice administrators and billing department to ensure staff is informed of contractual requirements and any changes in medical policy & billing policies.
- Conduct on-going assessments of payor mix, contract performance, regulatory changes and make recommendations for annual forecasts, strategic initiatives, goals, and objectives.
- Support the due diligence process, as required, for add-on practice expansion.
- Develop and maintain periodic reports on the status of all contracts.
- Assist with all contracting administration and projects, as needed.
- Five years of relevant experience with healthcare payor, clinic, or physician.
- Bachelor’s degree in health/business administration or related field or High School Diploma with five years relevant managed care experience
- Excellent contract negotiation skills.
- Demonstrated knowledge and understanding of healthcare industry, including ongoing compliance with specialty regulatory requirements.
- Willingness to actively participate in all aspects of the contract administrative process. This is a hands-on working role as opposed to a lead and direct staff role.
- Exceptional and proven provider partnership skills and interpersonal skills.
- Results driven, persistent – able to self-direct and work independently showing initiative, while seeking guidance when appropriate.
- Demonstrated strength in various computer software including MS Office Suite, PowerPoint, as well as proficiency in utilizing social media platforms and internet-based research.
- Demonstrated effective written, verbal, and electronic communication that is professional in both content and delivery.
- Ability to work as a team member, take initiative, exercise independent judgment, decision-making, and problem-solving expertise.
- Must have a valid driver’s license and a satisfactory Motor Vehicle Record (MVR)
Job Summary
Full Time
Ambulatory Healthcare Services
$104k-139k (estimate)
06/26/2024
12/15/2024
hughston.com
PHENIX CITY, AL
200 - 500
1949
Private
MARK BAKER
$50M - $200M
Ambulatory Healthcare Services
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About Hughston
Hughston is a provider of advanced orthopedic services and musculoskeletal trauma, sports injuries, spine and upper extremity treatments.
The job skills required for Payor Contract Manager Full Time include Contract Negotiation, Problem Solving, Initiative, Business Administration, PowerPoint, etc. Having related job skills and expertise will give you an advantage when applying to be a Payor Contract Manager Full Time. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Payor Contract Manager Full Time. Select any job title you are interested in and start to search job requirements.
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