Manager, Managed Care and Payer Contracting

Valley Health
Winchester, VA
Oct 02, 2021
Oct 18, 2021
Full Time
Who We AreValley Health System is a not-for-profit network of hospitals, urgent cares, physician practices, and services. Expanding across Virginia, West Virginia, and Maryland, we are devoted to the health of all who call our 18-county area home.A vital resource for healthcare, we are the region's largest employer, a dependable community partner, and are at the leading edge of clinical innovations.We are looking for passionate, innovative, and caring people who will each bring their unique skills and perspectives to our workplace.What You Will Do:The Manager, Managed Care and Payer Contracting supports the Director in the day-to-day management, including negotiation and development of payer agreements, monitoring of payer performance and adherence to contract terms, creating and/or managing analytical tools, including contract management software, that promote an environment of effective decision-making, maintaining tools to ensure accurate modeling and payment compliance, as well as support of Patient Financial Services operations in its revenue collection mission, support of corporate customers and patients, and support of business analytics and clinical programs. The Manager, Managed Care and Payer Contracting will work closely with and support providers, executives, entity and departmental leadership, corporate teams (provider credentialing, decision support, reimbursement/tax, budgeting, and service line leaders) and other healthcare system teams to support growth opportunities and develop financial/clinical products and services to meet the specific needs of network customers, as well as in the effective and timely delivery of quality financial/information products and services to VHS customers. Must maintain a positive attitude, goal-oriented attitude, promote the messaging of the organization, and maintain a professional and courteous demeanor with all interactions with all providers, coworkers, customers, superiors, and the general public. Critical thinking skills, ability to master new concepts and software applications, high energy, and an innovative spirit are essential traits for the successful candidate.What You Will Bring:EducationBachelor's degree requiredExperienceWorking knowledge of both Managed Care and Provider Insurance Credentialing requiredWorking knowledge of government and non-government insurance, payer requirements, and healthcare operations requiredWorking knowledge of healthcare revenue cycle, healthcare finance, CMS and state regulations and healthcare compliance requirements/activities requiredExperience in Epic preferredThree or more years in healthcare managed care contracting experience requiredQualificationsAbility to maintain positive working relationships with supporting customers, staff, peers, and leadershipAbility to support multiple customers simultaneouslyWorking knowledge of general accounting and healthcare finance requiredWorking knowledge of healthcare revenue cycle processes, including claims payment processesWorking knowledge of healthcare managed care and contractingWorking knowledge of technology alternatives applicable to healthcare contract managementWorking knowledge of Microsoft Office products, including Outlook, Word, Excel, and AccessExcellent verbal and written communication skillsWhat You Will Get:Competitive salaryFlexible schedulingHealth InsurancePaid Time OffWellness ProgramTuition AssistanceRetirement PlanLife Insurance*some benefits are subject to change due to job statusWe celebrate, support, and thrive on our differences for the benefit of our employees, our patients, and the communities we serve.We are neighbors caring for neighbors, and our goal is always to help those we serve get well, feel well, and stay well.EOECriminal Background ChecksVA State Police3rd party Background CheckFLSA ClassificationExemptGrade313INDD3Physical Demands1 A Abstractor/Analyst

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