Contract/Provider Service Manager, Senior

Discover Your Career at Emory University

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At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be.  We provide:

• Comprehensive health benefits that start day 1
• Student Loan Repayment Assistance & Reimbursement Programs
• Family-focused benefits
• Wellness incentives
• Ongoing mentorship, development, leadership programs...and more

Description

OVERVIEW:

• 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.

Additional Details

Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare’s Human Resources at [email protected]. Please note that one week's advance notice is preferred.