MultiCare Health System Looking for Payor Contract Manager Sr at Tacoma, WA  Full Time

Job Details

The reasons to work at MultiCare are as unique as the people who do. Join us for the professional challenges you seek. In the settings you prefer. With schedules that fit your life. Learn more at www.multicarejobs.org

Position Summary:
The Senior Payer Contract Manager is responsible for developing and implementing contracts with third party payers on behalf of MultiCare Health System and its affiliates. This role ensures MultiCare and our affiliates have consistent and well-functioning relationships with payers over time, in alignment with MultiCare’s vision and strategic priorities. The Manager will lead negotiations with assigned payers to include payment terms based on multiple reimbursement models, including fee-for-service payment terms, value based payment terms, and gain/risk sharing arrangements. The Manager serves as the lead managing the overall payer relationship, makes recommendations to Sr. Leadership on product participation, and will continually evaluate the payer relationship for opportunities to improve revenue, lower the cost of doing business, and to improve MultiCare’s access to patents. The Manager is accountable for negotiating contract language that aligns with all State and Federal laws and regulations, is consistent across payers, and does not expose MultiCare financial, legal, or operational risk to MultiCare or the payer.The Senior Payer Contract Manager will support the company’s business imperatives by leading the reimbursement strategy to support ensuring success in business objectives inclusive of pre-launch activities, collaboration with business development for compilation of a payer dossier and support of ongoing operations to ensure successful execution of public and private payer in-network strategies in laboratory environments for hospital and physician office clients.
Manager researches markets to identify and evaluate new contracting opportunities. Develops and grows strategic relationships with payers to positively impact negotiations and secure in-network coverage.
Collaborates internally to reply to payer compliance attestation requests, quality reporting, Medicare payer fee schedule requirements, and any additional payer requests by providing required information in accordance with regulatory requirements, payer contract terms, and MultiCare’ s policy and procedure.
Provides training, updates and collaboration with marketing, business development and leadership relative to contract changes, strategy and landscape changes in supporting market access objectives

Minimum Requirements:
Seven or more (7+) years of experience performing financial/medical data/payer mix analysis or contract negotiation in a healthcare environment, health system or health plan; Diagnostic or laboratory payer experience preferred
Experience with medical and pricing terminology to include but not limited to DRG, RUG, APC, RVU, Conversion Factors, G codes etc.

Education/Licenses/Certifications:
Bachelors degree with a major in finance, Healthcare administration, or related field; or 10+ years’ experience in Payer Contracting for a Health System or Health Plan as degree equivalent

Additional Information:
MultiCare welcomes and encourages all qualified applicants to apply. This position will work remotely but primary residence cannot be located in the following states: California, Connecticut, Florida, Hawaii, Illinois, Louisiana, Maryland/Washington DC, Massachusetts, Missouri, New Jersey, New York, Pennsylvania, and Vermont.

Compensation Range:
M26 – Min: $49.73-Max: $71.57