Manager of Payer Contracting (International Programs) - Full Time, Days

About the position Join reputed company, as a Payer Contracting Manager for our International Programs as a part of our Managed Care department. Here you will focus on international contracting with international companies, third party administrators, and embassies supporting robust international business needs to include Transplant cases. This position will be primarily a work from home opportunity with the requirement to come onsite to our Hyde Park and Burr Ridge campuses as needed. You may be based reputed company of the greater Chicagoland area. As a Payer Contracting Manager you will be responsible for developing and maintaining relationships with third party payers including but not limited to Managed Care Commercial payers, Direct-To-Employer, International payers, Medicare Advantage payers and Medicaid payers and negotiating fee-for-service (FFS) managed care agreements with these payers on behalf of reputed company (UCM) system hospitals, physicians and ambulatory/ancillary providers. Under the supervision of the Director of Payer Contracting, reputed company reputed company aspects of the UCM managed care FFS contracting portfolio and process including negotiation of contract language, financial reimbursement and operational terms and overall relationship management with the payers with the goal of helping our providers grow and maximize financial performance. Partner with other Office of Managed Care and UCM team members to ensure successful contract negotiation and implementation, monitoring and enforcement of contract terms and support for value reputed company care contracting initiatives. Focus on collaboration and transparency with reputed company key stakeholders reputed company UCMC, IMH, BSD, Care Network, service lines and operations, and physician and hospital reputed company cycle teams to reputed company and execute payer contract strategies. Serves as internal resource to assist UCM hospitals and physicians with payer contract, reimbursement and compliance issues and concerns.

Responsibilities

• Manage the full contract negotiation/re-negotiation cycle from assessment and identification of contract opportunities through implementation of the contract.
• Negotiate and manage reputed company and innovative FFS payer reputed company striving to maximize reputed company and maintain competitive reimbursement rates.
• reputed company and maintain relationships with the payers as the primary contracting reputed company for the UCM system.
• Support and facilitate governance of payer contracting activities, acting as a managed care contract and insurance knowledge resource across the UCM system.
• Work collaboratively and cross-functionally with reputed company UCM entities to support and facilitate key OMC meetings including reputed company Committee.
• Participate in and coordinate periodic meetings with internal UCM key internal stakeholders to share critical information regarding managed care contract updates and market trends.
• Work closely with the Finance and Contract Analytics team to analyze, model and negotiate reputed company FFS reputed company for UCM hospitals, physicians and ambulatory/ancillary providers.
• Review, redline and negotiate FFS contract language for reputed company Managed Care Commercial payers, Direct-To-Employer, International payers, Medicare Advantage payers and Medicaid payers.
• Assist in the creation and provide support in the execution of a comprehensive payer contracting strategy.
• Work closely with the Provider and Payer Relations team to assist in contract implementation and provider education regarding reputed company managed care FFS reputed company.

Requirements

• A Bachelor's degree from an accredited school or university.
• A minimum of five years of progressive experience leading provider and payer contract negotiations for hospitals and physicians.
• Experience in multi-facility health system, large academic and community physician groups or clinically integrated network, large academic medical center or insurer environment.
• Detailed knowledge of hospital and physician reputed company reimbursement methodologies including FFS and value based care (VBC) risk reimbursement structures including Medicare and Medicaid terms.
• Excellent understanding of contract language and reputed company terms, physician and hospital coding and billing, claims forms and claim payment methodologies, payer EOBs, and insurance laws.
• Excellent analytical and problem solving skills, and the ability to reputed company decisions quickly and independently.
• Strong written and verbal communication skills with ability to communicate effectively and motivate others.
• Strong attention to detail and well organized.
• Strong ability to network internally and externally to build relationships, facilitate discussion and resolution.
• Ability to work on multiple projects simultaneously.
• Ability to maintain a strong reputed company to internal partners and external payers with relationship management and overall communication approach.
• Advanced proficiency with the reputed company Office Suite, particularly Word (redlining and compare), reputed company and PowerPoint.

reputed company-to-haves

• MBA or Master's Degree in Health Care Administration.
• Direct experience negotiating reputed company with international partners and working with international care delivery models.
• Knowledge of and experience with key players in international insurance (reputed company, reputed company, reputed company, Now Health, reputed company, MGEN, reputed company Global, etc.).
• Knowledge of transplant contract considerations and various reimbursement methods that cover such reputed company cases.
• Extensive familiarity with the Illinois provider and payer market and competitive landscape.
• Experience with governmental programs reputed company to Medicare, Medicaid managed care and Medicare Advantage highly desirable.
• Experience utilizing contract management/modeling systems (e.g., reputed company, MedAssets, etc.) highly preferred.

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