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Baptist Memorial
Memphis
Summary Revenue integrity professionals will create value for our clinical areas, principally in revenue recovery and claim acceleration. This role requires extensive knowledge of Medicare Integrated Outpatient Code Editor (I/OCE) associated with Healthcare Common Procedure Coding System (HCPCS), Ambulatory Payment Classification (APC), HCPCS Modif
Job Source: Baptist MemorialBaptist Memorial
Memphis
Summary Coordinates and provides care utilizing the critical thinking framework known as the nursing process. The nursing process forms the foundation of the nurse's decision making to help partner with patients/families to attain, maintain and restore health whenever possible. Blends caring, compassion, knowledge and integrity to provide safe qual
Job Source: Baptist MemorialBaptist Memorial
Memphis
Summary Analyze, plan, design, maintain, and provide ongoing optimization and support of Baptist OneCare (Epic). Perform workflow assessments, capture business needs and analyze internal business system to determine functional requirements for optimal utilization. Possess in-depth clinical, financial, technical or application knowledge and experien
Job Source: Baptist MemorialBaptist Memorial
Memphis
Summary Assists in development, maintenance, and implementation of BHSG Professional Fee Schedule(s). Negotiates and prepares facility and ancillary contract documents as assigned and maintains BHSG facility and ancillary contract templates, including messengering to BHSG providers. Assists with operational administration of credentialing and recre
Job Source: Baptist MemorialBaptist Memorial
Memphis
Summary The System Director of Supply Chain Operations is responsible for the daily operations of all supply chain functions conducted within the system for all hospital and clinic facilities. Supply chain functions include, but are not limited to, inventory management, vendor relationship management, managing supply expense, all purchasing activit
Job Source: Baptist MemorialBaptist Memorial
Memphis
Summary Analyze, plan, design, maintain, and provide ongoing optimization and support of Baptist OneCare (Epic). Perform workflow assessments, capture business needs and analyze internal business system to determine functional requirements for optimal utilization. Possess clinical, financial, technical or application knowledge and experience. Perfo
Job Source: Baptist MemorialMonica Burt & Associates
Memphis, TN, United States
Job Description MB&A, a recruiting and consulting firm specializing in the medical device manufacturing industry, is seeking a qualified Contract Quality Engineer to join our team in Memphis, TN. This position is designed for a skilled professional who is dedicated to ensuring the highest standards of quality in the production of medical devices. T
Job Source: Monica Burt & AssociatesActalent
Memphis, TN, United States
Job Title: Contract Welding Engineer Job Description Actalent is seeking a Welding Engineer for a long-term contract opportunity. This would be a W2 position with per diem. As a Welding Engineer, you will be pivotal in eliminating waste of time, money, materials, person-hours, machine time, energy, and other resources that do not generate value.
Job Source: ActalentMemphis
Summary
Identifies, evaluates and negotiates contracting opportunities to grow the existing business, develop new business and expand provider network. In-depth understanding of health care and managed care contracting concepts, reimbursement, methodologies, and health benefit plan designs. Perceptive of general market conditions and the managed care market both provider and payor. Ensures application of appropriate business and legal protocol for contracting services to comply with organization and departmental missions. Serves as liaison for contract communication with other organizational representatives. Manages contract department, support staff, contract document control, and renewal process for payor contracts.
Responsibilities
+ Identifies and evaluates managed care contracting opportunities to grow the existing business, develop new business with various third party payors, including but not limited to insurance carriers, third-party administrators, managed care networks, self-funded payors, business alliances and provider organizations and to expand the provider network. Analyzes contract opportunities utilizing contract guidelines in order to improve organization's market share.
+ Negotiates contracts with various providers and third party payors. Manages the necessary interface to bring these negotiated contracts to closure and inform senior management of contract activity.
+ Maintains proficient knowledge of managed care contracting concepts, including but not limited to reimbursement methodologies, e.g., capitation, per diems, DRGs, case rates, and discounted fee-for-service; and, health benefit plan designs, including PPO, POS, EPO and HMO. Extrapolates information from payor's health benefit plans and health care reimbursement arrangements to complete contract summaries, contract information loadsheets and other reports as required to meet organizational obligations.
+ Maintains current knowledge of managed care market and market trends, both provider and payor.
+ Ensures that appropriate business and legal protocol are applied for contracting services to ensure compliance with organization and departmental missions; consults with legal on contracting issues.
+ Serves as liaison for contract communication with other organizational representatives; manages document control of contract file.
+ Manages renewal process for payor contracts, including renegotiation. Analyzes utilization data submitted for contract renewal by following contracting guidelines to monitor contract performance.
+ Performs other duties as assigned.
Requirements, Preferences and Experience
Education
Preferred: Masters degree in health care administration or related field
Minimum: Bachelors degree in health care administration or business administration.
Experience
Minimum: 3 years experience with health care contracting with health care reimbursement and health benefit plan experience.
Special Skills
Minimum: Effective in making effective presentations to various provider and payor groups; strong analytical, negotiation, leadership, marketing, and verbal/written communication skills.
About Baptist Memorial Health Care
At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry-healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups. Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey.
At Baptist, We Offer:
+ Competitive salaries
+ Paid vacation/time off
+ Continuing education opportunities
+ Generous retirement plan
+ Health insurance, including dental and vision
+ Sick leave
+ Service awards
+ Free parking
+ Short-term disability
+ Life insurance
+ Health care and dependent care spending accounts
+ Education assistance/continuing education
+ Employee referral program
Job Summary:
Position: 9486 - Manager-Provider Contracts
Facility: BMHCC Corporate Office
Department: HS Payer Contracting Corporate
Category: Leadership & Administration
Type: Non Clinical
Work Type: Full Time
Work Schedule: Days
Location: US:TN:Memphis
Located in the Memphis metro area REQNUMBER: 22028
Email Alert for Manager-Provider Contracts - HS Payer Contracting Corporate_ jobs in Memphis
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