UnityPoint Health Contract Manager - Managed Care in West Des Moines, Iowa
Responsible for the negotiation, implementation and ongoing evaluation of designated third-party payor arrangements. Make recommendations and act to ensure and enhance the success of hospital, physician and ancillary contracts. Decisions made by this individual have direct impact on the organization’s “bottom line.” Responsible for developing and maintaining strong communication with UnityPoint Health affiliates and third-party payors.
Evaluates contracts and leads negotiation third-party payor contracts for UnityPoint Health providers, as assigned
Oversees complex negotiations and the drafting of all contract documents.
Effectively articulates and conveys UnityPoint Health position regarding contractual needs.
Collaborates with Law Department and Revenue Cycle to ensure contracts meet system requirements.
Develops standard terms to be included in all new agreements and revises those, as needed, to account for changes in UnityPoint Health’s business needs.
Understands the financial impact of contract reimbursement.
Coordinates development of rate proposals and reviews rate analysis.
Implements and communicates executed contracts.
Directs maintenance of the tracking and trending of escalated issues with third-party payors.
Directs maintenance of current contract listing of third-party payors including reimbursement rates, where appropriate.
Works collaboratively with third-party payors to resolve escalated payment and contractual issues.
Manages relationship between UnityPoint Health and third-party Payor.
Acts as liaison between UnityPoint Health providers and third-party payors related to contractual, educational and communication requirements and issues.
Meets regularly with UnityPoint Health senior leaders to effectively communicate and coordinate payor-contracting activity.
Coordinates monitoring and analyzing of contract activity/performance.
Provides leadership to support system/department initiatives, assisting with resolution of operational issues.
Provides prioritization of work assignments and management of functional team resources, and their activities.
Participates in the preparation of staff development plans for Contract Specialists.
Supports strategic planning by providing accurate and timely data on the market and related trends.
Provides input on departmental plans, goals, standards, procedures and instructions which contribute to the effectiveness of the department in accordance with organizational goals.
Participates in the planning and monitoring of quality improvement activities within the department.
Assists with training and development of staff.
Bachelor’s degree in business related field.
Equivalent on-the-job training and experience (at least 10 years) will be accepted only if it applies to specific responsibilities of the position.
Experience in contract negotiation, contract legal review, and financial analysis.
Four (4) years of healthcare management or equivalent related experience.
Previous experience with third-party payors
High degree of effective oral and written communication skills and organizational skills.
Strong project management skills
Effective negotiation skills
Strong analytical and presentation skills
Excellent group facilitation and presentation skills, including the ability to communicate effectively with a wide variety of individuals and groups.
Ability to generate a quality work product in a timely manner while maintaining a strong attention to detail.
Knowledge of federal healthcare laws and regulations
Knowledge of various reimbursement methodologies
Ability to understand and interpret contract language and reimbursement methodologies for all types of healthcare providers
Ability to effectively utilize Microsoft Office programs to complete work (Word, Excel)
Strong attention to detail and well organized.
Adapts well to rapid change and multiple, demanding priorities.
Must be able to work on multiple projects simultaneously.
Ability to network internally and externally to build relationships, facilitate discussion and resolution.
Requisition ID: 2021-95073
Street: 1776 West Lakes Pkwy
Name: 9010 Administration
Name: Managed Care
FTE (Numeric Only; Ex. 0.01): 1.0
FLSA Status: Exempt
Scheduled Hours/Shift: Days, Business Need
External Company URL: http://www.unitypoint.org