What are the responsibilities and job description for the DE - Contracting and Payer Relations Executive Director - Dover position at Generis Tek Inc?
Please Contact: To discuss this amazing opportunity, reach out to our Talent Acquisition Specialist Jesse Antony at email address jesse.antony@generistek.com can be reached on # 630-576-1930.
We have Permanent role for Contracting and Payer Relations Executive Director for our client Dover, DE. Please let me know if you or any of your friends would be interested in this position.
Position Details:
Contracting and Payer Relations Executive Director- Dover, DE
Location : Dover, DE 19901
Project : Full-time/Permanent
Summary:
Client Medical Center is looking for a Contracting & Payer Relations Executive Director who is engaged in their profession, committed to providing the best service, and believes in the mission of Client. We are looking for staff with Compassion, Accountability, Respect, Integrity, and Teamwork. Whether you are seeking work/life balance or the excitement of never knowing what is coming in the door next, we can help connect you to your future!
Description:
Reporting to the CFO, the Executive Director of Contracting & Payer Relations is responsible for all aspects of managed care, governmental, value-based and population health/clinical integration for Client Medical Center and Client Medical Group. The position is charged with developing and improving relationships with third-party payers. As a key member of the Revenue Cycle team, the senior director ensures reimbursement rates are as robust as possible and that third-party payers are abiding by the contract terms. The Executive Director works collaboratively with the other Revenue Cycle leaders and key stakeholders to make certain that everyone is aware of, and strives to correct, issues or disagreements arising with payers.
Responsibilities:
About Generis Tek: generis tek is a boutique it/professional staffing based in Chicagoland. we offer both contingent labor & permanent placement services to several fortune 500 clients nationwide. Our philosophy is based on delivering long-term value and build lasting relationships with our clients, consultants and employees. Our fundamental success lies in understanding our clients’ specific needs and working very closely with our consultants to create a right fit for both sides. we aspire to be our client’s most trusted business partner.
We have Permanent role for Contracting and Payer Relations Executive Director for our client Dover, DE. Please let me know if you or any of your friends would be interested in this position.
Position Details:
Contracting and Payer Relations Executive Director- Dover, DE
Location : Dover, DE 19901
Project : Full-time/Permanent
Summary:
Client Medical Center is looking for a Contracting & Payer Relations Executive Director who is engaged in their profession, committed to providing the best service, and believes in the mission of Client. We are looking for staff with Compassion, Accountability, Respect, Integrity, and Teamwork. Whether you are seeking work/life balance or the excitement of never knowing what is coming in the door next, we can help connect you to your future!
Description:
Reporting to the CFO, the Executive Director of Contracting & Payer Relations is responsible for all aspects of managed care, governmental, value-based and population health/clinical integration for Client Medical Center and Client Medical Group. The position is charged with developing and improving relationships with third-party payers. As a key member of the Revenue Cycle team, the senior director ensures reimbursement rates are as robust as possible and that third-party payers are abiding by the contract terms. The Executive Director works collaboratively with the other Revenue Cycle leaders and key stakeholders to make certain that everyone is aware of, and strives to correct, issues or disagreements arising with payers.
Responsibilities:
- Negotiates agreements with third-party payers to achieve operating terms and reimbursement rates that will support Client’s strategic goals.
- Generates reports that describe the successes and opportunities in the revenue cycle.
- Meets with the leadership of Delaware-based plans to discuss strategic plans and opportunities for improvement and collaboration.
- Recommends managed care-contracting strategy to CFO.
- Serves as the primary source of communication and liaison with third-party payers.
- Fosters effective collaboration between departments to ensure a consistent and integrated approach in daily operations to managed care requirements.
- Collaborates with the Denials Department to create effective appeals.
- Conducts regularly scheduled meetings with third-party payers to improve payment processes and follow-up on claims due and other outstanding issues.
- Represents Client in statewide meetings and participate with regional associations.
- Accountable for the overall success of Client managed care strategy.
- Maintains the EPIC contract management system.
- Ensures that annual payment adjustments are accurate and complete.
- Creates Price Transparency machine-readable files each year.
- Serves on utilization review, level of care, and readmission committees.
- Negotiates single-case agreements as required.
- Provides input on charge master development and adjustments.
- All other duties as assigned, within the scope and range of job responsibilities.
- Education: Master Degree Business Administration
- Experience: Required: Minimum 10 years of contract negotiation with Managed Care Organizations
- Education: Master Degree Health Administration or Related field
About Generis Tek: generis tek is a boutique it/professional staffing based in Chicagoland. we offer both contingent labor & permanent placement services to several fortune 500 clients nationwide. Our philosophy is based on delivering long-term value and build lasting relationships with our clients, consultants and employees. Our fundamental success lies in understanding our clients’ specific needs and working very closely with our consultants to create a right fit for both sides. we aspire to be our client’s most trusted business partner.
