Job Description:
Responsible for ongoing management contracts and the overall relationships with assigned payers, serving as liaisons between Essentia Health and the payer. The scope of this relationship management will include managing the overall relationship between Essentia Health and the payers supporting revenue services, UM, population health, quality, and business development. Will also be responsible for the negotiation of fee for services and value based payer contracts for the full suite of services offered within Essentia Health. The negotiations will include both language and reimbursement terms, within defined parameters and processes. Qualified individuals are knowledgeable in coding, payer claim edits, varied reimbursement methodologies, and in health plan business practices. As subject matter experts for the assigned payers, these individuals will be responsible for the dissemination of policies, procedures, and programs to ensure Essentia Health success within the agreement. Work Experience: 2 years in managed care contract negotiation or provider/payer relations within a health plan or health system.
Education Qualifications:
Bachelor's degree required.
Licensure/Certification Qualifications:
No certification/licensure required.
FTE
1
Shift Rotation
Day/Eve Rotation (United States of America)
Shift Start Time
8 AM
Shift End Time
5 PM
Weekends
NA
Effective December 1, 2019: Job offers are contingent upon successful completion of a post-offer assessment, including a urine drug screen, immunization review, proof of required vaccinations, and background check. Essentia Health is committed to maintaining a work environment free from the influence of illegal drugs and alcohol.
Essentia Health EEO:
Essentia Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, sexual identity, national origin, disability, protected veteran status, or any other characteristic protected by law.
Equal Employment Opportunity (EEO) at Essentia
It is our policy to afford EEO to all individuals, regardless of race, religion, color, sex, pregnancy, gender identity, national origin, age, disability, family medical history, genetic information, sexual orientation, marital status, military service or veteran status, culture, socio-economic status, status with regard to public assistance, and other factors not related to qualifications, including employees or applicants who inquire about, discuss, or disclose their compensation or the compensation of other employees or applicants, or membership or activity in a local human rights commission, or any other category as defined by law.
