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Posted: Monday, January 8, 2018 7:59 AM

Primary Function:

Under the supervision of the VP of Payor Contracting and in collaboration with regional leadership, this role proactively develops and executes contracting strategies and tactics for assigned health plans, health systems, ACOs and other payors to improve EBITDA and administration for the contracted book of business.

Essential functions:

* Monitors pay for performance, overall contract performance, productivity and cash flow from contractual agreements by reviewing management reports of all company payor contracting, billing, collection and quality efforts.

* Seeks to understand any variance in actual vs. expected outcomes, recommends interventions and takes appropriate action.

* Models contract proposals, drafts contract terms, reviews and recommends strategy, negotiates, and finalizes new/renewed/renegotiated health plan, health system, ACO or other payor agreements.

* Identifies strategic opportunities to collaborate with payors on value based contracting initiatives to improve overall quality and patient engagement and to favorably impact total cost of care.

* Produces and reports on contractual performance.

* Provides subject matter expertise and educational tools to company locations regarding participation in payor programs and contracts.

* Conducts market research to develop strategies.

* Maintains relationships with vendors, payors, and other third parties in order to enhance strategic relationships.

* Monitors and maintains information system payor files for accurate and timely claim processing.


* Bachelor's degree in Business or related field. Master's degree preferred.

* Six (6 ) years experience in managed care contracting.

* Contracting experience in the home health and hospice fields preferred.

* Two (2 ) years supervisory experience.

* Demonstrated knowledge of managed care, including managed Medicare and Medicaid, and other payor's guidelines and criteria for reimbursement.

* Familiar with insurance billing, coding and terminology.

* Strong analytic computer and software skills.

* Excellent interpersonal skills including excellent verbal and written communication skills.

* Demonstrated knowledge of customer service skills when responding to questions and other inquiries from internal and external customers.



• Location: Baton Rouge

• Post ID: 32836137 batonrouge is an interactive computer service that enables access by multiple users and should not be treated as the publisher or speaker of any information provided by another information content provider. © 2018