Manager Payor Strategy & Relationship Management
Novant Health
Job Summary
The purview of Novant Health’s Revenue & Relationship Management team is leading the payor strategy, negotiation, and management of a portfolio of commercial and managed government payor contracts for the health system, to include value based care revenue risk. To do this increasingly compIex work, the Revenue & Relationship Management team partners within the department with the BDS Pricing Strategy team and outside the department with the medical group, revenue cycle services, care coordination teams, among others. The team also assumes corporate wide leadership in projects and other areas that intersect the payor-provider revenue space.Revenue & Relationship Management’s responsibilities are constantly evolving and currently represent key components of Novant Health’s strategic goals. The Manager, Payor Strategy and Relationship Management is a professional advisor supporting managed care contracts with health plans, payors, employer groups and specialty providers. The Manager may be responsible for certain portfolio of payer relations and the contract language and rate negotiations for the system. The Manager works with team members within the department as well as finance and reimbursement departments, clinical areas, business leaders, consultants, and executive level staff to answer internal operations management questions about managed care contracts. The manager fosters and maintains relationships with payer representatives and acts as a liaison between the department, revenue cycle services teams, finance, utilization management, and clinical leaders related to managed care contracting and performance monitoring.This position requires a wide range of expertise and experience in health insurance payment mechanisms, negotiations, contract language and adjudication, as well as a high degree of familiarity with existing and emerging healthcare economic trends.
Responsibilities
+ Specialty Contracting (transplant networks, commercial plan behavioral health)
+ Government contracting including Managed Medicaid
+ Single case agreements, Direct to Employer agreements
+ Revenue cycle services liaison
+ Value Based Care liaison between payor and Novant Health clinical teams
Qualifications
+ Education: Business Administration, Health Administration, Public Administration, or related field, required. Graduate Degree, preferred. Business Administration or Health Administration, preferred.
+ Experience:
+ Five years Payor/Provider Contracting, Provider / Payor Relations, Provider Servicing, preferred.
+ Three year Current experience with value-based programs, to include managed Medicare, preferred.
+ Three years Experience in behavioral health field desired, preferred.
+ Additional Skills (required):
+ Demonstrated knowledge of, and skill in, adaptability, change management, conflict resolution, customer service, decision making, influence negotiations, interpersonal relations, oral and written communication, prioritization, problem solving, quality management, systems thinking, teamwork, time management, leadership, facilitation, and project management.
+ Ability to work autonomously with initiative and follow-through; adapt in stressful situations, set priorities and remain flexible
+ Excellent communication skills, with tact, diplomacy, and ability to interact with all levels of management at Novant Health required
+ Represent team with business leadership, display executive presence and ability to influence others
+ Ability to work with teams and lead an organized work effort
+ Ability to function effectively in an environment with multiple and fluctuating priorities
+ Ability to work under deadlines and heavy workloads
+ Strong analytical, organizational, and interpersonal skills required
+ Proficient in Microsoft Office suite of products.
+ Possess an acute awareness of confidentiality of information
+ Comply with and proactively support departmental and organizational vision, strategic imperatives, and policies and procedures.
+ Additional Skills (preferred):
+ Ability to act on a suggested approach within guidelines of standards, procedures, and job role
+ Must be detail oriented in addition to having a global vision of current needs and future applications
+ Business process management experience
Job Opening ID
105010
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