Manager Revenue Management Managed Care | AdventHealth Corporate
Location Address: 2600 Lucien Way Maitland, FL 32751
Top Reasons To Work At AdventHealth Corporate
Immediate Health Insurance Coverage
Career growth and advancement potential
Full-Time, Monday - Friday
You Will Be Responsible For:
Responsible for securing provider effective dates with commercial and government payers as well as directing reimbursement analyst team to identify payment variances for professional fee commercial contracts and government payers.
Supports PE with securing missing provider effective dates and payment variance identification and liaisons with payer as needed to collaborate on resolution.
Screens, interviews, and hires qualified applicants for open positions.
Evaluates performance of immediate subordinates and makes recommendations for personnel actions.
Performs personnel management activities, including merit increases, promotions, transfers, and disciplinary actions.
Determines training and development programs for support staff and arranges such opportunities.
Closely works with MC enrollment, credentialing, contract administration to ensure effective dates are secured and loaded contracts are accurate and updated as required.
Maintain a working knowledge of current rules and regulations of Commercial and Government programs.
Oversees the review of missing provider effective dates and all manual contractual adjustments to determine cause, reducing future incidence by addressing training and procedural variances and bringing focus to bear on true underpayments for quick resolution.
Serve as AdventHealth’s subject matter resource for Commercial and Government payment variance identification, and education.
Meets with PE and MC management teams as required to provide monthly updates on current variance projects, future initiatives and specific payer issues.
Supplies analytical data to MC and PE leadership as needed.
Coordinates with billing support teams to provide guidance and education pertaining to effective date management and identified payment variances.
Completes special projects as assigned by the department director within the time frame requested.
Mentors direct reports
What You Will Need:
Bachelor’s Degree in Healthcare, Business Administration, or related field
Minimum of 7 years of relevant experience in healthcare reimbursement including Commercial and Government payers
5 years of managerial experience
Responsible for securing provider effective dates with commercial and government payers as well as directing reimbursement analysts who perform the work of evaluating professional fee contractual adjustments for accuracy in accordance with various payer contracts and/or federally mandated guidelines. This position oversees the payer follow-up and data entry of provider effective dates and payment variance identification for Managed Care (MC) on behalf of the Physician Enterprise (PE) and works closely with practice office operations staff, MC enrollment, credentialing, contracting and billing support teams to identify and recommend corrective action on securing effective dates and payment variances.
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.