Payer Contracting Specialist - Home Health

Are you passionate about the healthcare industry? Come join Healthy Living Network!We take pride in being a network of home health and hospice agencies operated by experienced professionals with extensive clinical, healthcare, and hospitality backgrounds. We enjoy working with those who put the patient and their loved ones first by finding ways to service individual needs. Our "At Your Service" philosophy allows us to empower employees to provide exceptional patient care.Healthy Living Network - "At Your Service!"The Payer Contracting Specialist is responsible for negotiating and managing complex contractual, legal and financial arrangements with payers to ensure that patients have superior access to the highest quality, cost-effective services.

Initiates, maintains and renews contracts effectively with a focus on improving reimbursement rates.

Develops and maintains productive and positive working relationships with key local, regional and national Payers through their local market managers and regional executives.

Updates and maintains fee schedules and policies.

Ensures compliance with Quality Programs (Ex. OCM, MIPS, MSSP) implemented by the practice.

Works closely with leadership to develop a strategic plan for negotiation and renegotiation of new Contracts and Amendments.

In conjunction with the billing manager, monitors Payor audits, billing changes and other insurance issues within the billing department.

Analyzes, negotiates, and monitors value-based contracts with payers, including the success of meeting financial and quality targets.

Reviews contract proposals, language and rate sheets to ensure accuracy, completeness and in compliance with company standards and guidelines.

Complies with all practice policies and procedures including the company's Code of Conduct.

Monitors contract performance and implementation; tracks and resolves potential issues including claims payments, reimbursement trends, and other operational issues.

Performs market, payor, and legislative research as needed and analyzes data.

Manages Credentialing to enroll agencies in payor networks and plans with emphasis on affiliation.

Performs other duties as assigned.

Basic Qualifications

Bachelor’s degree in business, health care administration or related field

At least three (3) years of experience working in a health care or managed care setting with a specific background in contract

HLNHPTo apply, send resume to: dkeller@healthylivingnet.comJob ID: 2020-4543 External Company URL: http://healthylivingnet.com/