Senior Contract Implementation Lead
7 days ago
About Us:
RWJBarnabas Health Corporate Services is a leading healthcare provider in New Jersey, dedicated to delivering high-quality patient care and advancing innovative strategies in education and research.
Job Description:
We are seeking an experienced Senior Contract Implementation Lead to join our team. In this role, you will be responsible for leading managed care payor projects, determining financial impact, and progress tracking. You will also work with outside vendors on projects relating to revenue recovery and strategic pricing assessments. Additionally, you will model financial impact of new technologies, provide timely notification to payers in accordance with contractual terms, and serve as a managed care resource across the organization assisting with reimbursement inquires, contractual rate grids, facility credentialing, and various ad hoc requests.
Key Responsibilities:
* Analytical lead on modeling contract rates throughout the managed care contract negotiation process
* Assist in varying aspects of managed care payor negotiations including proposals, rate validation, rebalancing, language review, and communication with insurance companies
* Evaluate payor performance relating to profitability, benchmarking, denials, contract compliance, and retrospective reviews
* Collaborate with the system business office to provide support relating to contract interpretation, denial reviews, payment variances, and cost-based audit reviews
* Supports the loading of payor contracts into the contract management system and validates accuracy at time of implementation
* Leads managed care payor projects in determining financial impact and progress tracking
* Works with outside vendors on projects relating to revenue recovery and strategic pricing assessments
* Research changes relating to managed care payor policies and determine financial impact to the health system
* Models financial impact of new technologies, and provides timely notification to payers in accordance with contractual terms
Requirements:
* Bachelor's degree in finance or accounting required
* 5 years of experience relating to healthcare reimbursement, strongly preferred
* Experience solving difficult problems relating to reimbursement, contract modeling, and revenue cycle functions, strongly preferred
* Strong analytical skills with ability to manipulate large data sets into meaningful information
* Advanced knowledge of Microsoft Excel, including formulas, lookups, and pivot tables
Benefits:
* Medical and Prescription Drug Insurance
* Dental and Vision Insurance
* Retirement Plans
* Short & Long Term Disability
* Tuition Reimbursement
* Health Care/Dependent Care Flexible Spending Accounts
Compensation:
The estimated salary range for this position is $90,000-$120,000 per year, based on industry standards and market conditions.
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