Providence Health & Services Manager, Payor Contracting in Irvine, California

Description:

Providence is calling a Manager, Payor Contracting to Providence Health & Services in Irvine, CA.

We are seeking a Manager, Payor Contracting to negotiates, monitors, and manages contracts and maintains relationships with HMOs, PPOs, other Payors and Providers established by the PSJH ED of Contracting in support of PSJH Strategic initiatives. Act as a liaison between the Contracting Department and other departments within PSJH and PSJH local Ministries.

In this position you will have the following responsibilities:

  • Negotiates contract terms and rates based on established targets to enhance revenue and limit financial risk. Helps create types of contracts negotiated, include, but are not limited to PSJH Hospital Ministry Payor agreements, one time LOA’s, and Ancillary Hospital Ministry agreements.

  • Actively promotes positive relations with contract payors and other health care providers. Promotes open communication by addressing issues and solving payment and other operational problems between the Hospital and the Payor.

  • Consults and collaborates with necessary hospital personnel to respond to payor needs.

  • Serves as a key resource to PSJH Ministries as a managed care expert, offering knowledge, training, education and assistance.

  • Participates in task forces, committees and group meetings formed to respond to managed care and non-managed care issues.

  • Assesses contract proposals, recommends action, respond to RFPs.

Qualifications:

Required qualifications for this position include:

  • Bachelor’s Degree

  • 2 years contract management / provider relations experience within the health care industry.

  • 2 years’ experience negotiating HMO/PPO contracts.

Preferred qualifications for this position include:

  • A Masters’ degree in a health-care management related field.

  • 4 years’ contract management/provider relations experience within the health care industry.

  • 4 years’ experience negotiating HMO/PPO contracts with three of the six years, in a hospital setting.

About the department you will serve.

Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence Health & Services from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

We offer a full comprehensive range of benefits - see our website for details

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Finance & Accounting

Location: California-Irvine

Req ID: 204437