- Managed Care
- Epic Certification
Allegheny Health Network
Job Description :GENERAL OVERVIEW:
Ensure Managed Care Contracts are loaded into Managed Care Contracts Management software correctly. Ensure payments versus modeled revenue are properly recorded into the system. Manage payer profiles and assist in contract modeling scenarios.
Ensure contracts are properly and timely loaded into MedAssets Contract Modeler. (50%)
Perform quality assurance on contracts in the system. (10%)
Investigate discovered payment variance for contract non-compliance. (10%)
Work with Director and Vice President to model contracting scenarios for new proposals. (10%)
Develop less experienced staff in Contract Manager and in various contracting scenarios. (10%)
Work with Patient Accounts, EPIC staff, Patient Access and other hospital departments on Managed Care Payer and system issues. (5%)
Direct other staff in preparing Single Case Agreements and Payer Credentialing forms for Vice President approval. (5%)
Perform other duties as assigned or required.
Bachelor's degree or higher advanced degree, preferably with a focus on finance or accounting
5 years healthcare finance experience preferably in managed care
Experience in healthcare finance, patient financial services, managed care, hospital reimbursement, hospital cost account or hospital decision support
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