Location: US:PA:Hershey Work Type: Full Time FTE: 1.0 Shift: Day Hours: 9:00a-5:00p
SUMMARY OF POSITION:
Reporting to the Director of Managed Care for Penn State Health (PSH), this position is responsible for the overall maintenance of the various contract management tools utilized by PSH (nThrive, Cerner Soarian) while ensuring expected reimbursement is accurately reflected within the systems.
Maintain contract management systems based on payor agreements and update as needed for rate updates, contract methodology changes, and / or regulatory updates. Review variance reports and work with Revenue Cycle to ensure system is adjudicating claims correctly.
Support contract negotiations by modeling contract proposals and ad-hoc scenarios at the direction of Third Party Contracting leadership. Understand and analyze chargemaster changes to determine the impact on modeling and net revenue.
Perform sophisticated data analytics; build new and modify existing complex models to create predictive impact decision making tools; project revenue and/or cost increases by using analytic techniques; and projects different targets based upon various analytics.
Work with Third Party Contracting regarding insurance company contracts to review the overall impact of revenue for all Penn State Health agreements. Identify opportunities for maximizing net revenue.
Maintain a database of payor contract documentation for each payor, including contract summary documents, copies of all fully-executed contracts with related amendments, letters, and notices.
Maintain Third Party Contracting documents used for analyses.
KNOWLEDGE, SKILLS & ABILITIES:
Excellent verbal and written communication skills; strong computer and software skills, and ability to remain organized and efficient.
Ability to analyze data, draw meaningful conclusions and provide appropriate level of thoughtful recommendations to finance leadership, as well as other operational leaders.
Possesses and can demonstrate strong analytical, documentation and problem-solving skills.
Ability to build positive working relationships in a matrixed organization.
Bachelor Degree in Finance, Accounting, Business, Health Administration, or a related field
Two (2) years of related experience.
Minimum four (4) years of experience in a Healthcare setting with functional knowledge / experience with Managed Care Contracting or Reimbursement.
Experience with Microsoft Office, Excel, Access, relational databases, and reporting tools preferred.
Working knowledge of healthcare terminology and provider reimbursement methodologies.
If chosen for this position, you may required to pass a Post Offer Employment Physical Exam in accordance with the measurements listed in the Work Task Analysis (WTA) report. This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. All individuals (including current employees) selected for a position will undergo a background check appropriate for the position's responsibilities.
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