Payor Contracting Specialist Phoenix AZ in Phoenix, AZ – Panoramic Health – vsmartpros

Job title: Payor Contracting Specialist Phoenix AZ Company: Panoramic Health Job description: Payor Contracting Specialist Phoenix, AZ, USA Req #206 Monday, January 23, 2023 Panoramic Health Come Join our team!! At Panoramic Health our mission is to improve outcomes for patients by slowing disease progression and improving quality of life. We are a data-driven health care management company with operations in multiple states. Our organization is designed to help physicians, practices, patients, and payors navigate and shape the changing healthcare environment while driving improvements in outcomes. We are one of the nation’s leading physician-led nephrology organizations, with more than 800+ providers and 900+ employees, supporting nephrologists who provide care across 19 states. The Panoramic Health value-based care delivery platform is driven by proprietary, predictive data analytics and clinical workflows underpinned by one of the world’s largest clinical chronic kidney disease (“CKD”) data warehouses that enable nephrologists to deliver better patient outcomes and value-based care We are seeking a qualified candidate for the position of Specialist, Payor Contracting. This is an excellent opportunity to continue to use your experience in a fast-paced, growing, and dynamic healthcare services company. We are looking for someone who is enthusiastic, organized, hard-working, and able to work with various stakeholders. In this position you will work with external customers (e.g., health plans) and internal customers to support our contract review, communication, and management system. This position locates in Arizona. Essential Responsibilities: · Serves as the initial point of contact to establish contracts with health plans in various markets. · Work with Director, Payer Contracting and SVP, Payer Contracting to review contract and identify negotiation opportunities. · Summarize and synthesize contract to bring proposal to executive level for final approval and signature. · Communicate key terms of executed contracts to internal partners, including Revenue Cycle. · Serve as a liaison between Revenue Cycle Management and health plan to resolve any questions involving executed contracts. · Serve as the initial point of contact for matters defined in a health plan’s contract for administrative disputes that arise with health plans in the normal course of business. Partner with appropriate individuals in the organization to bring closure to those administrative disputes. · Develop and maintain a contract management system, including housekeeping and filing of existing contracts and accurate tracking of status of existing contracts, including any amendments and notices. · Alert senior and executive leaders as contracts are coming up for renewal or re-negotiation and set in motion a process to keep all contracts current. · Maintain an accurate inventory of healthcare individual providers, groups and locations in the database that are common inputs to health plan contracts. · Perform market-level research, in partnership with other functions, to understand the payers and health plan products in the market and identify any gaps in contracting. · Serve as a subject matter expert on health plan architecture, product offerings, network restrictions, authorization, referral and other components of the health plan marketplace. · Manage special projects related to payer market research, payer contracting, rate negotiation, and overall management of all GNS fee-for-service or value-based contracts. Education/Experience Requirements: · 2+ years of experience in health care services, preferably medical services or managed care. · At least 1 year of experience in network contracting within a medical group or managed care. · Bachelor’s Degree in a related field required, Master’s Degree preferred. · Excellent written and oral communication skills. · Expert proficiency in Microsoft Office, including Outlook, SharePoint, Excel, and PowerPoint. · Demonstrated leadership ability. Competency Requirements: Must possess the following knowledge, skills and abilities to perform this job successfully: · Knowledge and experience with provider contracting. · Knowledge and experience with health plan markets. · Knowledge and experience with health plan products. · Knowledge and experience with health plan benefits. · Ability to communicate effectively and clearly with all internal and external customers. · Go-getter, detail-oriented with excellent follow up. · Solutions-minded, compliance-minded and results-oriented. Work Environment: · Extensive telephone and computer usage. · Use of computer mouse requires repetitive hand and wrist motion. · Time off restricted during peak periods. · Regular reaching, grasping, and carrying of objects. The Company is committed to the principles of equal employment. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment which is free of harassment, discrimination, or retaliation because of age, race, color, national origin, ancestry, religion, sex, pregnancy (including childbirth, lactation and related medical conditions), physical or mental disability, genetic information (including testing and characteristics), veteran status, uniformed servicemember status, or any other status protected by federal, state, or local laws. The company is dedicated to the fulfillment of this policy in regard to all aspects of employment, including but not limited to recruiting, hiring, placement, transfer, training, promotion, rates of pay, and other compensation, termination, and all other terms, conditions, and privileges of employment For information about our Privacy Policy, please visit Other details • Job Function Clinical • Pay Type Salary • Travel Required No • Required Education Bachelor’s Degree Expected salary: Location: Phoenix, AZ Job date: Thu, 23 Mar 2023 08:59:20 GMT Apply for the job now! Apply tot his job Apply To this Job