- The Director will serve as the leader of a team of dispute resolutions representatives, arbitrators, and reporting and invoicing analysts.
- Based on recommendation from the team arbiters, the Director will serve as the final authority on the arbitration decision.
- Works with the Guidehouse banking teaming partner to ensure payments are appropriately invoiced and provided.
- Represent Guidehouse and the team with providers, payors and CMS as required.
- Bachelor's Degree or High School Diploma with appropriate years' experience.
- 10 years experience with CMS and Managed Care Contracts
- 5 years experience negotiating complex contracts for providers or payors
- Experience with the adjudication of hospital complex claims
- Relevant certifications preferred
- Arbitration education and/or experience welcome
- Remote role with moderate travel (20%)
- Medical, Rx, Dental & Vision Insurance
- Personal and Family Sick Time & Company Paid Holidays
- Position may be eligible for a discretionary variable incentive bonus
- Parental Leave
- 401(k) Retirement Plan
- Basic Life & Supplemental Life
- Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
- Short-Term & Long-Term Disability
- Tuition Reimbursement, Personal Development & Learning Opportunities
- Skills Development & Certifications
- Employee Referral Program
- Corporate Sponsored Events & Community Outreach
- Emergency Back-Up Childcare Program
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Director / (Associate Director) of Independent Dispute Resolution - Gardena, United States - Guidehouse
Description
Job Family:
PFS General
Travel Required:
Up to 25%
Clearance Required:
None
What You Will Do:
Guidehouse is seeking a Director / (Associate Director) of Independent Dispute Resolution team.
This individual will manage/lead a team of 10-20 associates arbitrating respective payor and provider reimbursement offers under the Center of Medicare and Medicaid Services (CMS) No Surprises Act (NSA).
What You Will Need:
What Would Be Nice To Have:
# Li-Remote
The annual salary range for this position is $120,500.00-$180, Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
What We Offer:
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
Guidehouse is an Equal Employment Opportunity / Affirmative Action employer.
All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at or via email at All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.
