What are the responsibilities and job description for the Independent Dispute Resolution (IDR) Project Manager position at NorthStar Anesthesia?
Role Overview
Are you ready to lead and drive meaningful change? At NorthStar Anesthesia, our Independent Dispute Resolution (IDR) Project Manager will command the federal IDR process end-to-end, shaping out-of-network strategies, managing high-stakes arbitration, collaborating with industry leaders, and implementing innovative solutions to deliver impactful results!
The Independent Dispute Resolution (IDR) Project Manager will be responsible for leading and overseeing all elements of the federal IDR arbitration and related processes. This position will develop and implement the organization’s out-of-network and arbitration strategy, handle all disputes related to out-of-network claims, and manage and coordinate with third-party arbitration vendors engaged to ensure timely and accurate outcomes.
Essential Functions:
- Lead and manage the federal IDR process end-to-end, and handle all disputes related to out-of-network claims
- Track open negotiation timelines, submit necessary documentation, ensure compliance with regulatory deadlines related to arbitration, and ensure timely and accurate payment
- Identify and evaluate third-party IDR vendors, serve as the key point of contact, and manage and coordinate any third-party vendors the organization engages to ensure effectiveness and drive results
- Work with leadership to develop and implement the organization’s out-of-network and arbitration strategy
- Analyze and estimate the financial impact of arbitration and related out-of-network activities
- Identify and create relevant analytics databases, dashboards and reporting related to the arbitration process and outcomes
- Ensure adherence to NSA provisions and relevant state laws regarding billing and dispute resolutions, coordinating with legal and compliance teams
- Monitor regulatory updates and ensure compliance with arbitration-related laws and guidelines
- Identify and implement process improvements for out-of-network claim submissions, payment tracking, and reporting to enhance efficiency
- Analyze and improve workflows for arbitration and claims processing
- Build and maintain strong relationships with arbitrators, third-party vendors, legal professionals, and other stakeholders
- All other duties as assigned.
About The Facility
At NorthStar Anesthesia, we offer competitive benefits and a supportive environment where your career can thrive. We provide 4-5 weeks of paid time off, 11 paid holidays, annual HSA contributions, a 401(k) match, and more. Join a team that values your expertise and is committed to your growth!
We are committed to Diversity, Equity, and Inclusion. We understand that women and others from underrepresented minority groups may hesitate to apply unless they meet every qualification. We encourage you to apply, even if you don't meet all the criteria - your unique perspectives and experiences are valued here.
NorthStar is an Equal Opportunity Employer. We do not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status, or any other basis covered by appropriate law. We are committed to having a workforce that celebrates diversity, equity, and inclusion. We are an Affirmative Action Employer.
Qualifications
- Bachelor’s degree and 5-10 years’ experience in healthcare administrative function (e.g., revenue cycle management)
- Experience with out-of-network medical claims, arbitration, or dispute resolution, as well as arbitration platforms and processing vendors and systems
- Strong knowledge and deep familiarity with federal and state regulations regarding out-of-network billing
- Strong project management skills, with experience managing dispute resolution processes, claims processing or similar activities
- Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies
