Director - Managed Care Revenue Contracting

Company: Oklahoma Heart Hospital, LLC
Location: Oklahoma City
Posted on: May 23, 2020

Job Description:

The OHH Director of Managed Care and Revenue Contracting position is responsible for all aspects of managed care and direct revenue contract management including negotiation, analysis interpretation, implementation, maintenance of the contracts performance, and payer relations. The position is also responsible for coordination and communication between managed care and other key stakeholder departments and Leadership.  This position will be responsible for developing new and existing relationships with third party payers to ensure competitive reimbursement rates and contract language attainable through the revenue cycle operations.  Will oversee payer credentialing.  Will assist departments with various payer prior authorization, eligibility, protocol, referrals, enrollment, billing issues, and education that relate to contracting.    Will manage the denials and appeals staff and processes and report payer outcomes and trends as it relates to applicable denials.  Communicates with respective payers related to trends and compliance with contract parameters. Responsibilities Development of new and existing relationships with third party payers to ensure competitive reimbursement rates and contract language attainable through the revenue cycle operations. Oversight of Payer credentialing. Assists departments with various Payer prior authorization, eligibility, protocol, referrals, enrollment, billing issues, and education that relate to contracting Manages the denials and appeals staff and processes and reports payer outcomes and trends as it relates to applicable denials. Qualifications Bachelors Degree in Business, Finance, Accounting, Healthcare Administration, other related field required. Minimum of five (5) years of experience in the healthcare management managed care environment required; including third-party contracting, negotiating, reimbursement and analysis. Minimum of three (3) years of experience in a management capacity. Preferred experience in managing, analyzing and reporting denials and appeals. Must have effective communication, facilitation, interpersonal and professional diplomacy skills. Strong attention to detail with ability to manage multiple priorities while meeting timelines.

Keywords: Oklahoma Heart Hospital, LLC, Oklahoma City , Director - Managed Care Revenue Contracting, Other , Oklahoma City, Oklahoma