Payer Contracting
Payer Contracting - Assistant Director*
Job Description:
ASSISTANT DIRECTOR, PAYER CONTRACTING
FULL-TIME SALARIED BENEFITED POSITION
Rush Health, an Affiliate of Rush University Medical Center, is a clinically integrated network of providers working together to improve health through high quality, efficient health services covering the spectrum of patient care from wellness, prevention and health promotion to disease management and complex care management.
POSITION DESCRIPTION:
Responsible for developing and maintaining relationships with third party payers and negotiating managed care agreements with these third party payers on behalf of Rush Health Participating Physician practices' and Rush System for Health hospitals' (Members). This responsibility also includes management of referral contracts with other physician organizations. This position shall also assist in Member education regarding payer agreements and in monitoring and enforcing payer compliance with contract terms. This position is pivotal to capturing and retaining business for the organization and improving the financial performance of third party payer agreements. Exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures.
QUALIFICATIONS:
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Bachelor's degree minimum or equivalent experience required
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At least five (5) years experience in managed care environment with direct payer contract experience required
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Master's degree in Health Care Administration or Business preferred
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Experience with multi-facility health system, large academic medical center or insurer environment highly desired
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Specific and thorough understanding of physician and hospital coding, claim forms, payer EOBs and reimbursement methodologies
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Understanding of contract law desirable
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Strong written and verbal communication skills required
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Stong analytical and problem solving skills required