Reviews, reports and proesses information, policies, and programs across all payers. Understands healthcare reimbursement methodology, including fee for service, per diem, APC, fee schedule, risk, medicare, based and ACO arrangements. Knowledgeable of health benefit plan designs, including PPO, CDHP, POS, EPO and HMO. Applies approporiate business and legal protocol for contracting services to ensure compliance with organizational and departmental missions. Presents leadership new programs within payers that are available to leadership.
Experience --Minimum Required
One to two years in health-care contracting
Proficient computer skills with emphasis on database creation and management. Excellent computer skills, excellent verbal and written communication. Managed care and government contracting knowledge.
Educated --Bachelor's Degree in Business, Finance or related field or equivalent experience.
Three or more years in health-care contracting. Experience in managed care and government contracting and negotiating experience.
Understanding of general principals of health-care reimbursement and familiarity with the health insurance industry.