Current jobs related to Manager - Contract Management and Payer Variance - Wilmington - ChristianaCare
-
Property Manager
2 weeks ago
Wilmington, Delaware, United States Capano Management Full timeJob Description**Job Summary**Capano Management is seeking a highly skilled and experienced Residential Property Manager to join our team of professionals. The successful candidate will be responsible for managing the financial, physical, and social aspects of our residential communities.**Key Responsibilities**Maintain the community and common areas in...
-
Property Manager
4 months ago
Wilmington, United States Capano Management Full timeJob DescriptionJob Description*** Capano Management is seeking skilled and experienced Residential Property Manager to join our growing team of professionals.The Property Manager will primarily be focused on managing the financial, physical and social aspects of the community. The Property Manager is a full-time position and will report directly to upper...
-
Contract Manager
7 days ago
Wilmington, Delaware, United States Stellar Innovations Full timeContract ManagerWe are seeking a skilled Contract Manager to join our housing division in Freiburg, Germany. As a key member of our service team, you will be responsible for managing our diverse real estate portfolio and ensuring the ecological use and maintenance of federal natural areas.Our social and entrepreneurial mission is to create socially...
-
Nurse Manager
3 weeks ago
Wilmington, Delaware, United States ChristianaCare Full timeJob SummaryChristianaCare is seeking a highly skilled and experienced Nurse Manager to lead our Case Management Department. As a key member of our healthcare team, you will be responsible for managing the daily operations of the department and providing effective and efficient discharge planning services to patients.Key ResponsibilitiesManage the daily...
-
Nurse Manager
6 days ago
Wilmington, Delaware, United States ChristianaCare Full timeNurse Manager - Care Management Job DescriptionChristianaCare is seeking a skilled Nurse Manager to lead our Care Management team in Wilmington, Delaware.Job Summary:The successful candidate will be responsible for managing the daily operations of the Care Management team, providing expert guidance and support to staff and leadership, and ensuring effective...
-
Proposal and Contract Manager
4 days ago
Wilmington, North Carolina, United States Catalyst Clinical Research LLC Full timeJob Title: Proposals and Contracts ManagerCatalyst Clinical Research LLC is seeking a highly skilled Proposals and Contracts Manager to join our Business Operations, Proposals & Contracts Team. As a key member of the team, you will play a crucial role in shaping the company's future success by leading proposal development and contracts management.Key...
-
Contract Management Specialist
2 weeks ago
Wilmington, Delaware, United States DelDOT Full timeAbout the RoleDelDOT is seeking a highly skilled Contract Management Specialist to join our team. As a key member of our Employment and Training team, you will be responsible for managing contracts, ensuring compliance with federal and state laws, and providing technical assistance to subcontractors.Key ResponsibilitiesNegotiate and develop cost...
-
Residential Community Operations Manager
2 weeks ago
Wilmington, Delaware, United States Capano Management Full timeJob OverviewCapano Management is in search of a talented and experienced Residential Community Operations Manager to enhance our dedicated team of professionals.The Community Operations Manager will be primarily responsible for overseeing the financial, physical, and social elements of the residential community. This is a full-time role that will report...
-
Restaurant General Manager
3 weeks ago
Wilmington, United States Hospitality Group Full timeHospitality Group- Restaurant General ManagerFine Dining/Catering/Events/WineNorth Wilmington DERestaurant General Manager Job Duties:· Meets restaurant financial objectives by developing financing; preparing strategic and annual forecasts and budgets; analyzing variances; initiating corrective actions; establishing and monitoring financial controls;...
-
Nurse Manager
1 day ago
Wilmington, Delaware, United States ChristianaCare Full timeJob Title: Nurse Manager - Care ManagementChristianaCare is seeking a highly skilled and experienced Nurse Manager to lead our Care Management team. As a key member of our healthcare team, you will be responsible for managing the daily operations of the Care Management department and providing effective and efficient discharge planning services to...
-
Nurse Manager
2 weeks ago
Wilmington, Delaware, United States ChristianaCare Full timeNurse Manager - Case ManagementChristianaCare Wilmington Hospital is seeking a skilled and experienced Nurse Manager to lead our Case Management Department. As a key member of our team, you will be responsible for managing the daily operations of the department and providing effective and efficient discharge planning services to patients.Key...
-
Nurse Manager
3 weeks ago
Wilmington, United States ChristianaCare Full timeNurse Manager - Case Management Day Shift (Hours: 8a-4:30) No Weekends or Holiday Wilmington, DE ChristianaCare Wilmington Hospital is looking for an energetic, motivated Nurse Manager for our Case Management Department to manage the daily operations of the Care Management department staff and to provide effective and efficient discharge planning services...
-
Nurse Manager
4 days ago
Wilmington, Delaware, United States ChristianaCare Full timeJob Title: Nurse Manager - Case ManagementChristianaCare Wilmington Hospital is seeking an experienced Nurse Manager to lead our Case Management Department. As a key member of our team, you will be responsible for managing the daily operations of the department and providing effective discharge planning services to patients.Scope, Purpose, and Frequency of...
-
Nurse Manager
1 day ago
Wilmington, Delaware, United States ChristianaCare Full timeJob Title: Nurse Manager - Case ManagementChristianaCare Wilmington Hospital is seeking an experienced Nurse Manager to lead our Case Management Department. As a key member of our team, you will be responsible for managing the daily operations of the department and providing effective discharge planning services to patients.Scope, Purpose, and Frequency of...
-
Nurse Manager
2 weeks ago
Wilmington, Delaware, United States ChristianaCare Full timeNurse Manager - Case ManagementChristianaCare Wilmington Hospital is seeking a highly motivated and experienced Nurse Manager to lead the Case Management Department. The ideal candidate will have a strong background in case management and a proven track record of success in managing teams and implementing effective care management processes.Key...
-
Nurse Manager
5 days ago
Wilmington, Delaware, United States ChristianaCare Full timeJob Title: Nurse Manager - Case ManagementWe are seeking a highly skilled and experienced Nurse Manager to lead our Case Management Department at ChristianaCare Wilmington Hospital.Job Summary:The successful candidate will be responsible for managing the daily operations of the Care Management Team, providing expert guidance and support to staff and...
-
Nurse Manager
1 week ago
Wilmington, Delaware, United States ChristianaCare Full timeNurse Manager - Case ManagementChristianaCare Wilmington Hospital is seeking a highly motivated and experienced Nurse Manager to lead the Case Management Department. The successful candidate will be responsible for managing the daily operations of the department, providing effective and efficient discharge planning services to patients, and ensuring...
-
Nurse Manager
2 weeks ago
Wilmington, Delaware, United States ChristianaCare Full timeNurse Manager - Case ManagementChristianaCare Wilmington Hospital is seeking a highly motivated and experienced Nurse Manager to lead the Case Management Department. The successful candidate will be responsible for managing the daily operations of the department, providing effective and efficient discharge planning services to patients, and ensuring...
-
Nurse Manager
3 weeks ago
wilmington, United States ChristianaCare Full timeNurse Manager - Case Management Day Shift (Hours: 8a-4:30) No Weekends or Holiday Wilmington, DE ChristianaCare Wilmington Hospital is looking for an energetic, motivated Nurse Manager for our Case Management Department to manage the daily operations of the Care Management department staff and to provide effective and efficient discharge planning services...
-
Nurse Manager
2 weeks ago
Wilmington, Delaware, United States ChristianaCare Full timeJob SummaryWe are seeking a highly skilled and experienced Nurse Manager to lead our Case Management Department at ChristianaCare Wilmington Hospital. As a key member of our team, you will be responsible for managing the daily operations of the department and providing effective discharge planning services to patients.Key Responsibilities:Manage the daily...
Manager - Contract Management and Payer Variance
4 months ago
Are you looking for a career opportunity with growth potential at a healthcare organization that is based on excellence and love?
ChristianaCare is one of the country's most dynamic healthcare organizations, centered on improving health outcomes, making high-quality care more accessible, and lowering healthcare costs. ChristianaCare includes an extensive network of outpatient services, home health care, urgent care centers, three hospitals (1,299 beds), a free-standing emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care, and women's health. It also includes the pioneering Gene Editing Institute and was rated by IDG Computerworld as one of the nation's Best Places to Work in IT. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. It is continually ranked by U.S. News & World Report as the Best Hospital. With the unique CareVio data-powered care coordination service and a focus on population health and value-based care, ChristianaCare is shaping the future of health care.
ChristianaCare Offers
- Full Medical, Dental, Vision, Life Insurance, etc.
- Two retirement planning offerings, including 403(b) with company contributions
- Generous paid time off with annual roll-over and opportunities to cash out
- 12-week paid parental leave
- Incredible Work/Life benefits including annual membership to care.com, access to backup care services for dependents through Care@Work, retirement planning services, financial coaching, fitness and wellness reimbursement, and great discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets and much more
About This Position
ChristianaCare is searching for a Manager of Contract Management and Payor Variance to maintain and oversee day-to-day operations related to management of all managed care payor contract agreements and government reimbursement policies for both the system’s acute and medical group services. This position will also be responsible for the accurate and timely build, as well as maintenance of all contract terms within the patient financial system. The Manager will also provide knowledge of contract language and payor reimbursements to support revenue cycle staff, finance, and others, including vendor partners.
Principal duties and responsibilities:
Work collaboratively with payor contracting team, billing managers, payor variance staff, finance, other internal caregivers, and with external staff regarding the identification and timely resolution of contract variance issues, ensuring appropriate payor reimbursement and accuracy of monthly financial net revenue and net accounts receivable reporting.
Manage all additions, revisions, and updates to contract management system for fee schedules, payer policy changes, annual contract renewals, recurring updates to government regulations, pricing corrections, and payor plan mappings for the accurate net down of all claims.
Liaise across revenue cycle to ensure contract terms/reimbursement policies are interpreted and applied accurately and uniformly. Recognize and resolve contract issues and schedule claim repricing as needed, communicating this process with all impacted.
Maintain governmental pricing as per CMS Final Rule/Change Notice releases (Medicare) and Department of Human Services (Medicaid). Ensure accurate governmental pricing through management of facility-specific Medicare and Medicaid factors, DRG version changes, and Medicare physician fee schedules within PFS contract management system.
Work with reporting team to create and develop payor variance reporting to identify discrepancies in payments compared to expected. Perform daily audit to identify any pricing concerns from system related or contract build issues, as well as identification of patterns in payor payment behavior.
Resolve and communicate issues to pertinent parties.
Provide analysis to assist in identifying underpayments to recover lost revenue. Analyze and resolve recurring payment issues and provide communication to help support more favorable payor contract negotiations.
Monitor payer reimbursement policies for changes and regulatory updates. Review communications received from third party payers and share information with impacted personnel. Maintain current knowledge of regulatory requirements related to third party billing & reimbursement.
Field pricing inquiries, originating from billing and follow-up, patient access, revenue integrity, and finance teams. Respond to inquiries regarding third party payer guidelines, CMS policies, and billing department protocols, advising caregivers accordingly.
Perform as main contact for contract pricing inquiries and work related to price estimates tool.
Maintain payor/plan contract list inclusive of effective dates for the ongoing tracking and verification of all payor contracts received and loaded into contract management system. Ensure all health plans on system’s insurance master file have current active contract terms set up in PFS.
Prepare and revise policies and procedures as warranted and conduct in-service/meetings with caregivers.
Coordinate training and education to initiate process improvement.
Monitor caregiver productivity and performance. Provide feedback and take appropriate action when necessary.
Assist in the development of annual departmental goals and objectives.
Attend, participate, and conduct departmental staff and management staff meetings.
Adhere to and review routinely with staff, established departmental safety rules and practices.
Perform other duties, as required.
Education and experience requirements:
Bachelor’s Degree and/or equivalent work experience.
A minimum of eight years of healthcare billing/accounts receivable or payor contract management experience preferred.
Extensive knowledge of payor contracting, third-party/managed care reimbursement and contract management systems required.
Demonstrated experience with motivating and managing staff.
