Payer Performance Manager

2 weeks ago

Springfield IL United States Navient Full time

Xtend Healthcare is nationally recognized as the industry-leading provider of comprehensive revenue cycle solutions to hospitals and health systems. Sustaining healthcare revenue cycle improvement is our exclusive focus with experience in all 50 states and more than 30 years of dedicated health revenue cycle experience. We are committed to delivering solutions built around the broad revenue cycle needs of our clients.

Xtend Healthcare focuses on both clinical and financial interoperability to maximize collection of net revenue. Xtend Healthcare provides an array of solutions for our customers including full and partial revenue cycle outsourcing, third-party insurance follow-up, self-pay, coding, CDI, and consulting services.

THIS POSITION CAN BE REMOTE IN CHICAGO, IL or ON-SITE AT MT. SINAI HOSPITAL.

The Payer Performance Manager will have healthcare data analytics, informatics and a healthcare revenue cycle background. This role will assist Xtend clients in ensuring that payers are paying according to their contract guidelines. This role will also include payer denial analysis, trending and report building. The Payer Performance Manager will work with all areas of Revenue Cycle to ensure reimbursement for the hospital.  The analyst will be required to produce weekly reporting on weekly financials and payer issues as well as manage all the payer meetings, including creating the payer agenda, reporting claim issues and working directly with payer representatives for claim resolution. The Analyst will work with Xtend proprietary tools to analyze large volumes of hospital data. The role will require various technical data manipulation techniques to analyze large complex data sets, identify data patterns, data mine, etc. Candidates must communicate data trends to Revenue Cycle Leadership as well as Payer Representatives.

JOB SUMMARY:

1.   Analyze large volumes of hospital data and weekly/monthly reporting   

           

2.   Employ various techniques to analyze large complex data sets:   

  • Data manipulation
  • Data mining
  • Identifying data patterns

3.   Weekly Revenue Cycle and Payer Reporting                         

  • Communications

4.   Payer Meetings- (Contracted Insurance Carriers)

  • Preparing meeting agenda
  • Running Payer meetings
  • Following up for any action items related to payer meetings

MINIMUM REQUIREMENTS:

  • High school diploma with some college - Business, Informatics, Data Analytics, Finance, Accounting , or a related field (additional equivalent experience above the required minimum may substitute for the required level of education)
  • 3+ years working with data in a hospital billing/claims environment (additional equivalent education above the required minimum may substitute for the required level of experience)
  • 2+ years working with Government and Commercial payers or equivalent years of experience with payer contracting
  • Advanced level proficiency with Microsoft Excel required
  • SQL or other database software experience

PREFERRED QUALIFICATIONS:

  • Meditech or other EMR experience preferred
  • Illinois Medicaid payer knowledge
  • Bachelor’s Degree Preferred
  • Acute attention to detail and strong analytical skills (required)
  • Strong understanding of Revenue Cycle, Commercial and Government Payers
  • Strong written and verbal communication skills
  • Ability to employ critical thinking skills and work independently while also working well within a team environment
  • Receptiveness to differing views and ideas with the ability to apply industry-specific concepts
  • Highly adaptable to changing circumstances and/or directives in day-to-day priorities
  • Ability to perform well on frequent repetitive tasks while continually improving skills and competencies
  • Comfortable in faced paced working environment
  • Ability to manage and complete short- and long-term projects
  • Ability to set and meet deadlines
  • Willingness to travel occasionally

All offers of employment are contingent on standard background checks. Navient and certain of its affiliated companies are federal, state and/or local government contractors. Should this position support a Federal Government contract, now or in the future, the successful candidate will be subject to a background check conducted by the U.S. Government to determine eligibility and suitability for federal contract employment for public trust or sensitive positions. Positions that support state and/or local contracts also may require additional background checks to determine eligibility and suitability.

EOE Race/Ethnicity/Sex/Disability/Protected Vet/Sexual Orientation/Gender Identity. Navient Corporation and its subsidiaries are not sponsored by or agencies of the United States of America.

Navient is a drug free workplace.

  • Payer Performance Manager

    3 weeks ago

    Springfield, IL, United States Navient Full time

    Xtend Healthcare is nationally recognized as the industry-leading provider of comprehensive revenue cycle solutions to hospitals and health systems. Sustaining healthcare revenue cycle improvement is our exclusive focus with experience in all 50 states and more than 30 years of dedicated health revenue cycle experience. We are committed to delivering...

  • Payer Performance Manager

    3 weeks ago

    Chicago, IL, United States Navient Full time

    Xtend Healthcare is nationally recognized as the industry-leading provider of comprehensive revenue cycle solutions to hospitals and health systems. Sustaining healthcare revenue cycle improvement is our exclusive focus with experience in all 50 states and more than 30 years of dedicated health revenue cycle experience. We are committed to delivering...

  • Payer Performance Manager

    3 weeks ago

    Chicago, IL, United States Navient Full time

    Job DescriptionXtend Healthcare is nationally recognized as the industry-leading provider of comprehensive revenue cycle solutions to hospitals and health systems. Sustaining healthcare revenue cycle improvement is our exclusive focus with experience in all 50 states and more than 30 years of dedicated health revenue cycle experience. We are committed to...

  • Payer Performance Manager

    2 weeks ago

    SPRINGFIELD, United States Navient Full time

    Xtend Healthcare is nationally recognized as the industry-leading provider of comprehensive revenue cycle solutions to hospitals and health systems. Sustaining healthcare revenue cycle improvement is our exclusive focus with experience in all 50 states and more than 30 years of dedicated health revenue cycle experience. We are committed to delivering...

  • Payer Performance Manager

    3 weeks ago

    Springfield, United States Navient Full time

    Xtend Healthcare is nationally recognized as the industry-leading provider of comprehensive revenue cycle solutions to hospitals and health systems. Sustaining healthcare revenue cycle improvement is our exclusive focus with experience in all 50 states and more than 30 years of dedicated health revenue cycle experience. We are committed to delivering...

  • Manager, Payer Relations

    2 months ago

    Springfield, Illinois, United States Springfield Clinic Full time

    The Payer Relations Manager is responsible for assisting with the financial and administrative oversight of payer relations and contracting with commercial payers on behalf of Springfield Clinic. Works closely with departmental staff and Clinic physicians to develop and maintain a portfolio of participating network contracts. Ensures internal support is...

  • Senior Consultant, Payer Marketing for Pharma

    2 months ago

    Hopkins, MN, United States Optum Full time

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...

  • RN Case Manager, Medical Clinic

    2 weeks ago

    Springfield, IL, United States Hospital Sisters Health System Full time

    Throughout communities in Illinois and Wisconsin, 15 hospitals, numerous community-based health centers and clinics, our 15,000+ colleagues have built a culture based on our solid core values of respect, care, competence, and joy. Built upon more than 145 years of service to the communities we serve, we now look to the future and our place in it as a health...

  • Transportation Operations Manager

    24 minutes ago

    Springfield, Massachusetts, United States Performance Foodservice Full time

    Job Summary:We are seeking a highly skilled Transportation Supervisor to join our team at Performance Foodservice. As a key member of our operations team, you will be responsible for overseeing the safe and efficient transportation of goods to our customers.Key Responsibilities:Supervise and train drivers to ensure compliance with Department of...

  • Transportation Manager

    2 months ago

    Springfield, Illinois, United States PERFORMANCE FOOD GROUP Full time

    103121BR Job Title: Transportation Manager Location: CM Columbus, OH (2248) Job Description: We Deliver the Goods: Competitive pay and benefits, including Health & Wellness Benefits on Day 1, Employee Stock Purchase Plan, RRSP, Paid Direct Drug Card, & Scholarship Opportunities for children of associates, Paid Time Off, and much more Growth opportunities...

  • RN, Hospital Case Manager Full Time

    1 month ago

    Springfield, United States Baystate Health Full time

    Summary The Hospital Case Manager is a registered nurse responsible for the coordination of clinical care, quality, and financial outcomes of a designated population of patients. The Hospital Case Manager is responsible for overseeing an efficient plan that will ensure continuity and effective community or post acute reentry. The Hospital Case Manager leads...

  • Clinical Case Manager

    5 days ago

    Springfield, Georgia, United States Effingham Hospital Inc. Full time

    Job SummaryWe are seeking a highly skilled and compassionate RN Case Manager to join our team at Effingham Hospital Inc. as a key member of our Transitional Care department.Key ResponsibilitiesAssess and plan effectively to meet patient needs, manage the length of stay, and promote efficient utilization of resources.Collaborate with interdisciplinary teams...

  • Warehouse Operations Manager

    11 hours ago

    North Springfield, Vermont, United States Performance Foodservice Full time

    Job SummaryWe are seeking a highly skilled and experienced Warehouse Supervisor to join our team at Performance Foodservice. As a key member of our operations team, you will be responsible for overseeing the daily activities of our warehouse, ensuring that all orders are fulfilled accurately and efficiently.Key ResponsibilitiesSupervise Warehouse Staff: Lead...

  • Registered Nurse

    4 days ago

    Springfield, Massachusetts, United States Baystate Health Full time

    Job Summary:Baystate Health is seeking a highly skilled Registered Nurse to fill the role of Hospital Case Manager. As a key member of our healthcare team, you will be responsible for coordinating clinical care, quality, and financial outcomes for a designated population of patients.Responsibilities:Develop and implement comprehensive care plans that ensure...

  • RN CASE MANAGER

    3 months ago

    Springfield, United States Effingham Hospital Inc. Full time

    Job DescriptionJob DescriptionDescription:Are you interested in building a career with other TOP PERFORMERS?.. Committed to providing exceptional care and services in an environment that supports professional growth, diversity, and inclusion.Every team member's experience and work-life balance are a priority in our organization.EHS culture encourages and...

  • RN Case Manager

    4 days ago

    Springfield, Georgia, United States Effingham Hospital Inc. Full time

    Job SummaryEffingham Hospital Inc. is seeking a highly skilled RN Case Manager to join our team. As a RN Case Manager, you will be responsible for coordinating patient care and ensuring the efficient utilization of resources.Key ResponsibilitiesAssess patient needs and develop effective care plansCollaborate with interdisciplinary teams to ensure seamless...

  • RN CASE MANAGER

    2 months ago

    Springfield, United States Effingham Health System Full time

    Job Type Full-time Description Are you interested in building a career with other TOP PERFORMERS?.. Committed to providing exceptional care and services in an environment that supports professional growth, diversity, and inclusion. Every team member's experience and work-life balance are a priority in our organization. EHS culture encourages and supports...

  • Senior Vice President of Supply Chain Management

    2 weeks ago

    Springfield, Illinois, United States Performance Food Group Full time

    Job Title:Senior Vice President of Supply Chain ManagementLocation:Performance Food GroupJob Overview:We Provide Exceptional Value:Competitive compensation and benefits package, including immediate access to Health & Wellness Benefits, Employee Stock Purchase Plan, 401K Employer Matching, Education Assistance, Paid Time Off, and more.Opportunities for...

  • Performance Improvement Specialist

    3 days ago

    Marseilles, IL, United States Constellation Energy Full time

    Performance Improvement Specialist - Sr Performance Specialist ***********************This role may be filled at the Performance Improvement Level, the Sr Performance Specialist Level. Please see minimum qualifications list below for each level********************** COMPANY OVERVIEWAs the nation's largest producer of clean, carbon-free energy,...

  • RN CASE MANAGER

    3 months ago

    Springfield, United States Effingham Hospital Inc. Full time

    Job DescriptionJob DescriptionDescription:Are you interested in building a career with other TOP PERFORMERS?.. Committed to providing exceptional care and services in an environment that supports professional growth, diversity, and inclusion.Every team member's experience and work-life balance are a priority in our organization.EHS culture encourages and...