Contract Administrator, System Payer Contracting - Albany
13 hours ago
Job description
Department/Unit:
Integrated Delivery SystemsWork Shift:
Day (United States of America)Salary Range:
$71, $110,999.20The Contract Administrator, System Payer Contracting ("Contract Administrator") makes data-supported recommendations, supports the development of AMHS contracting strategies, and, as assigned, negotiates with established and new payers, both commercial and governmental. Support functions include but are not limited to economic and risk assessments in collaboration with System Finance and ensuring implementation and operational performance of such contracts, consistent with the negotiated terms. The Contract Administrator prepares contract proposals for internal review and consideration, prepares for and conducts meetings/negotiations, presentations, and other organizational functions as assigned. The Contract Administrator maintains strong relationships working collaboratively across AMHS and payer organizations. This includes but is not limited to coordinating operational input across all applicable System departments including Practice and Hospital Administration, Billing, Finance, Information Systems, Utilization Management, Quality, Credentialing, Managed Care Organizations, payer, and other related internal and external entities. For each AMHS contract portfolio the Contract Administrator assists with the development of reporting instruments including but not limited to contract performance parameters and/or profit/loss comparisons by service. The Contract Administrator works collaboratively within the Department to develop payer profiles to include but not limited to membership, market share, financials, products and volumes at AMHS.The Contract Administrator, System Payer Contracting meets with representatives of payers, managed care organizations and other agencies to assist in the evaluation of current contracts or development of new contracting opportunities to include those under Federal and NYS reform for AMHS. Reviews proposals and makes data informed recommendations for internal consideration in preparation for negotiations.
In conjunction with the Director or at the direction of VP for Payer Contracting negotiates contract parameters and methodologies and prepares/presents proposals representing AMHS's position. Works cross functionally across AMHS to evaluate and develop such proposals identifying opportunities and risks. Presents such opportunities and risks as directed. Collaborates with the Legal and Compliance Department and other departments across AMHS to ensure compliance and implementation capabilities.
Works cross functionally across AMHS to review terms and performance of each established contract portfolio; makes data informed recommendations for methodology changes including but not limited to those related to value based payment identifying opportunities and risks.
Mediates contract disputes to resolution and ensures compliance (both internally and externally) with contract provisions.
Monitors contract renewal dates to ensure appropriate review is conducted. Coordinates with Finance and others to ensure timely/applicable contract analyses. Reviews for risks and works collaboratively with Financial Reporting to ensure appropriate modeling. Understands all modeling parameters and reports on such.
Responsible for contract education to various System-wide departments, including executive leadership, Finance, Billing, Practice Administration as required. Responds to requests for further information and follow-up as required.
Plans presentations and meetings including preparing narrative, overheads and handouts as assigned. Ensures accurate reporting in all prepared presentations for documentation/archiving.
Monitors contract performance by independently collecting data, analyzing and completing spreadsheets to include comparative and economic assessments and reports on such. Works collaboratively with Data Analytics to develop routine reporting instruments for AMHS.
Maintains broad knowledge of payers in the AMHS market and beyond, whether contracted or not. Assists with gathering of current data on all major managed care organizations, including information regarding: financials, current membership, physician networks and current/future marketing plans. Assists with the development of and prepares/presents reporting instruments for the AMHS.
Maintains the absolute confidentiality of patients and AMHS contracts,
Promotes and contributes positively to System-wide, intra-departmental and inter-departmental relationships by cooperating with the resolution of conflicts which may develop.
Performs special projects and assignments as requested by the Director or VP for Payer Contracting. Assists with IDS Affiliate contracting processes related to payer contracting.
Knowledge base must remain current in changes regarding Federal and New York State regulations of provision/reimbursement of medical services including but not limited to federal and NYS VBP Roadmaps.
QUALIFICATIONS
Education
Bachelor's Degree in Business and/or Health Care Administration
required
Master's Degree in Business and/or Health Care Administration
preferred
Equivalent combination of relevant education and experience may be substituted as appropriate
4-6 years in managed care negotiations and managed care network operations
required and 1-3 year in and able to lead complex payer negotiations and mediation.
Thank you for your interest in Albany Medical Center
Albany Medical is an equal opportunity employer.
This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:
Access to information is based on a "need to know" and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.
Similar jobs
Department/Unit: · Integrated Delivery Systems · Work Shift: · Day (United States of America) · Salary Range: · $71, $110,999.20The Contract Administrator, System Payer Contracting ("Contract Administrator") makes data-supported recommendations, supports the development of AMHS c ...
1 hour ago
The Director of System Payer Contracting oversees payer contracting strategies including building external payer relationships. · Negotiates complex payer contracts. · Drafts contract proposals. · ...
4 days ago
The Director is responsible for overseeing as well as implementing, developing, maintaining, and benchmarking contractual relationships with payers/health plans in the AMHS market.Contributes to System payer contracting strategic planning, budgets, and evaluation of payer partner ...
4 days ago
Department/Unit: · Integrated Delivery SystemsWork Shift: · Day (United States of America)Salary Range: · $133, $213,959.93This position is required to be in person and in office. The candidate will be required to attend and host in person meetings. · The Director is responsible ...
3 days ago
This position is responsible for overseeing and implementing contractual relationships with payers/health plans in the AMHS market. · Leading and mentoring negotiates continuous monitoring of contract performance engaging with internal external stakeholders to optimize contracts ...
2 days ago
Department/Unit: · Integrated Delivery SystemsWork Shift: · Day (United States of America)Salary Range: · $106, $170,567.54The Assistant Director is responsible for implementing, developing, and maintaining contractual relationships with payers/health plans in the AMHS market. Ne ...
13 hours ago
Department/Unit: · Integrated Delivery Systems · Work Shift: · Day (United States of America) · Salary Range: · $106, $170,567.54The Assistant Director is responsible for implementing, developing, and maintaining contractual relationships with payers/health plans in the AMHS mark ...
1 hour ago
The Contract · Analyst is responsible for ensuring · the integrity of the payments received...This position will work with staff and management across the revenue cycle... · ...
3 weeks ago
The Contract Variance Analyst is responsible for ensuring the integrity of the payments received for services rendered at AMHS are paid according to the signed contractual arrangement. · This position will work with staff and management across the revenue cycle which will enable ...
2 weeks ago
Project Manager, System Payer Contracting and Value Based Initiatives
Only for registered members
Department/Unit: · Integrated Delivery SystemsWork Shift: · Day (United States of America)Salary Range: · $86, $134,309.04The Project Manager, System Payer Contracting and Value Based Initiatives assists in the definition of project scope and objectives, involving all relevant s ...
13 hours ago
Project Manager, System Payer Contracting and Value Based Initiatives
Only for registered members
Department/Unit: · Integrated Delivery Systems · Work Shift: · Day (United States of America) · Salary Range: · $86, $134,309.04The Project Manager, System Payer Contracting and Value Based Initiatives assists in the definition of project scope and objectives, involving all relev ...
1 hour ago
The Epic Tapestry Analyst is responsible for the build, · configuration, implementation, and support of the Epic Tapestry (Managed Care/Payer) module. · Configure and maintain Epic Tapestry (Payer/Managed Care) application components. · Build and support benefit plans, products, ...
1 week ago
We are seeking a Revenue Cycle Manager who will lead and optimize the revenue cycle management function across ENT, allergy, and audiology operations.This individual will guide payer strategy, resolve systemic denial issues, and ensure monthly key performance indicators are being ...
2 weeks ago
We are seeking a Revenue Cycle Manager who will lead and optimize the revenue cycle management function across ENT, allergy, and audiology operations. · Responsible for full ownership of the revenue cycle management function. · ...
1 week ago
The Patient Access Senior Associate is responsible for the capture of demographic and insurance information either by telephone or patient facing. · Responsible for creating encounters in ADT representing service patient is receivingResponsible to discern demographic and insuranc ...
2 weeks ago
The Contract Administrator makes data-supported recommendations and supports the development of AMC/IDS contracting strategies. They negotiate with established and new payers and prepare contract proposals for internal review. · ...
1 week ago
The Insurance Discovery and Estimate Representative will have a strong working knowledge of third-party payer regulations, interpretation of payer contracts, and the ability to ensure payment and accurate estimates. · Review all self-pay encounters to identify insurance or determ ...
2 weeks ago
We are seeking an experienced Javelina Plan Builder to join our team on a long-term contract basis. · Review and analyze Business Requirement Documents (BRDs) to develop accurate build plans in Javelina. · Execute plan building activities with precision and efficiency. · Collabor ...
1 week ago
Under the direction of the Chief Executive Officer, the EVP is responsible for driving growth and market expansion across the system. This role leads initiatives in network development and strategic partnerships to advance access and value-based care. · ...
1 month ago
The Insurance Discovery and Insurance Cost Estimate Representative will have a strong working knowledge of third-party payer regulations; interpretation of payer contracts and applying contractual agreement to ensure payment and accurate estimates. Ability to be the liaison for c ...
1 week ago