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Emory Healthcare/Emory University Senior, Contract/Provider Service Manager in Decatur, Georgia

Overview

Join a broad team of professionals creating new approaches to contracting with payer clients including ACO and Medicare Advantage Value Based Contracts. Seeking a highly motivated managed care professional who is an innovative and critical thinker with creative approaches to problem solving. Analytical experience a plus.

Description

JOB DESCRIPTION:

  • Independently assesses, analyzes, and negotiates payer contracts for all hospital and professional entities within Emory Healthcare (EHC).

  • Manages information for loading and maintaining payer contracts in EHC decision support systems. Implements new contracts, amendments, and business process modifications.

  • Manages provider service relationships for assigned payer organizations and assigned EHC provider entities, by managing contract interpretation for operational issues and problem resolution.

  • Determines and manages revenue enhancement opportunities for EHC entities through enhanced contract management.

  • Manages the balance of contract negotiations and provider service interests through dual responsibility.

  • Performs other related duties as required.

MINIMUM QUALIFICATIONS:

  • Bachelor's degree required. Master's degree preferred.

  • Four years experience required, but prefer seven years of healthcare related experience, preferably in a complex Provider or Payer managed care organization.

  • Demonstrates innovative and critical thinking with creative approaches to problem solving.

PHYSICAL REQUIREMENTS (MediumMax 25lbs): up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.

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Division Emory Healthcare Inc.

Campus Location Decatur, GA, 30030

Campus Location US-GA-Decatur

Department EHI Contracting

Job Type Regular Full-Time

Job Number 39620

Job Category Revenue Cycle & Managed Care

Schedule 7a-4p

Standard Hours 40 Hours

Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.

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