Contract/Provider Service Manager, Senior

Overview

Be inspired. Be valued. Belong.

Benefits at Emory Healthcare include:

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

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

• 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)

Environmental Factors

• Factors affecting environment conditions may vary depending on the assigned work area and work tasks.
• Environmental exposures include, but are not limited to:
• Blood-borne pathogen exposure
• Bio-hazardous waste
• Chemicals/gases/fumes/vapors
• Communicable diseases
• Electrical shock
• Latex
• Lighting
• Patient care/handling injuries
• Radiation
• Shift work
• Travel may be required

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 careers@emoryhealthcare.org.

Please note that one week's advance notice is preferred.