Payer Contracting Manager - Children's Health

Intermountain Health

10d • $59 - $90 • Onsite

About The Position

The Payer Contracting Manager is responsible for effective management of assigned payer contracts, including supporting contract negotiations and relationships. This leadership role manages all aspects of assigned payer contracts, including contract management, relationship management, dispute resolution, rate negotiation, and internal coordination. This position specifically supports the Children's Health Payer Contracting in Nevada to include the Pediatric Clinically Integrated Network, the Professional and Facility contracting needed for Intermountain Health's Nevada Children's Hospital. This role is based in Las Vegas, Nevada. Our preferred candidates will live in, or be willing to relocate to, the area. Essential Functions Manages all aspects of assigned payer relationships, including supporting contract language negotiation and management, rate and methodology research and negotiation, dispute resolution, and relationship management. Maintains ongoing expertise of all assigned contracts, including contract/amendment language and structure, rates, methodologies, and contracted providers/facilities. Ensures all contract language, documentation, negotiation, payment rate, payment methodology, contract storage, and escalated contract issues follow Payer Contracting standard practices. Represents Payer Contracting and Intermountain Health in key relationships, including leading Joint Operating Committees. Establishes and maintains effective long-term relationships with highly aligned payers. Coordinates with Finance and Revenue Cycle leadership for the implementation of risk-based contracting, and proactive care, strategies and initiatives. Coordinates with Legal and Compliance to ensure contract accuracy, regulatory compliance, and language consistency. Provides leadership and mentorship to Payer Contracting Managers.

Requirements

• Experience leading and supporting complex negotiations.
• Experience in a professional role that requiring effective verbal and written communication to present advanced topics in a clear, concise, polished, and professional manner.
• Demonstrated ability to synthesize extensive amounts of data into clear and concise summaries without sacrificing material details.
• Experience leading teams, including cross-functional teams.
• Demonstrated experience mentoring teams and caregivers.

Nice To Haves

• Proven experience in payer contracting, including full-cycle negotiation and contract redlining.
• Demonstrated success negotiating pediatric or children’s health contracts, from either the provider or payer perspective.

Responsibilities

• Manages all aspects of assigned payer relationships, including supporting contract language negotiation and management, rate and methodology research and negotiation, dispute resolution, and relationship management.
• Maintains ongoing expertise of all assigned contracts, including contract/amendment language and structure, rates, methodologies, and contracted providers/facilities.
• Ensures all contract language, documentation, negotiation, payment rate, payment methodology, contract storage, and escalated contract issues follow Payer Contracting standard practices.
• Represents Payer Contracting and Intermountain Health in key relationships, including leading Joint Operating Committees.
• Establishes and maintains effective long-term relationships with highly aligned payers.
• Coordinates with Finance and Revenue Cycle leadership for the implementation of risk-based contracting, and proactive care, strategies and initiatives.
• Coordinates with Legal and Compliance to ensure contract accuracy, regulatory compliance, and language consistency.
• Provides leadership and mentorship to Payer Contracting Managers.

Benefits

• In addition to the annual salary, to show our commitment to you and assist with your transition,, we may offer a sign-on and relocation bonus when applicable.
• With this position, you are eligible to participate in the Annual Pay for Performance (AP4P) Plan.
• This plan enables Intermountain Health to provide leaders with an additional performance compensation opportunity.
• The AP4P award opportunities are calculated as a percentage of your base salary.
• Awards are paid out based on attainment of selected Board-approved goals.
• We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
• Intermountain Health’s PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution.
• The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates.
• Caregivers are eligible to participate in PEAK on day 1 of employment.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed