Healthcare Reimbursement Strategist

3 days ago


Southfield, Michigan, United States MyCareer Full time
About the Job

MyCareer is seeking a skilled Healthcare Reimbursement Strategist to join our team. As a key member of our healthcare administration team, you will be responsible for developing and implementing value-based reimbursement strategies, fostering payer relations, and overseeing Accountable Care Organization (ACO) initiatives.

Key Responsibilities
  • Value-Based Reimbursement
    • Develop and implement strategies to maximize value-based reimbursement opportunities.
    • Analyze financial and operational data to identify trends and opportunities for improvement.
    • Collaborate with clinical and financial teams to ensure alignment with value-based care objectives.
  • Payer Relations and Contract Negotiations
    • Establish and maintain strong relationships with insurance payers and other healthcare partners.
    • Negotiate contracts and agreements with payers to ensure favorable terms and compliance with regulatory requirements.
    • Serve as the primary point of contact for payer-related issues and resolution.
    • Strategize and execute payer contract negotiations to optimize financial performance and reimbursement.
  • Accountable Care Organization (ACO) Management
    • Oversee ACO initiatives, including performance monitoring, reporting, and compliance.
    • Develop and implement strategies to improve quality of care, patient satisfaction, and financial performance within the ACO.
    • Coordinate with clinical and administrative staff to ensure effective implementation of ACO programs and initiatives.
  • Regulatory Compliance
    • Ensure compliance with all federal, state, and local regulations related to value-based reimbursement and ACO operations.
    • Stay current with changes in healthcare regulations and payer requirements.
    • Develop and implement policies and procedures to maintain regulatory compliance.
  • Data Analysis and Reporting
    • Conduct detailed analyses of reimbursement trends and financial performance.
    • Prepare and present reports to senior management, highlighting key insights and recommendations.
    • Utilize data to drive decision-making and strategic planning.


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