INTEGRIS Health
Overview
Payer Contracting Specialist
role at
INTEGRIS Health
— INTEGRIS Health Corporate Office, Oklahoma’s largest not-for-profit health system, located in Oklahoma City, OK. In this position, you’ll be part of our Payor Strategy team providing exceptional work supporting the INTEGRIS Health caregivers and the community at large. If our mission of partnering with people to live healthier lives speaks to you, apply today and learn more about our recently enhanced benefits package for all eligible caregivers, including front loaded PTO, 100% INTEGRIS Health paid short term disability, increased retirement match, and paid family leave. We strive to be The Most Trusted Partner for Health. Responsibilities
The Payer Contracting Specialist serves as the expert resource and contact for Revenue Integrity contract negotiations and payer analysis. Assists in the administration of payer contracting and financial analysis activities for all INTEGRIS facilities, employed/managed physicians and ancillary services providers. The responsibilities include, but are not limited to, the following (3-5 core functions, approximately 75-80% of time): Maintains contact with Managed Care Organizations, Third Party Administrators, Employer Groups as well as internal staff within INTEGRIS Health. Assists in contract negotiations with payers to obtain the most favorable contract language as well as terms of reimbursement necessary to achieve financial goals. Assists in the design of payer contracting strategies to meet the financial, operational, and strategic needs of the organization. Develops payer statistics through the creation of payer report cards. Facilitates problem solving of operational issues through collaboration with Managed Care Organizations and internal stakeholders. Facilitates, negotiates and coordinates the implementation of single case agreements for facility services as well as securing approval for non-standard reimbursement arrangements. Assists in ensuring compliance with INTEGRIS Health's Legal and Corporate Compliance Departments policies and State and Federal compliance codes. Reports to the System Manager Payer Contracting and Financial Analytics. This position may have additional or varied physical demand and/or respiratory fit test requirements. Please consult the Physical Demands Project SharePoint site or contact Risk Management/Employee Health for additional information. Normal office environment. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status. Qualifications
Bachelors degree in Business or other healthcare related field required; an additional 4 years of related experience may be substituted in lieu of a degree. Masters degree in healthcare, business administration or related field preferred. 3 years experience in managed care contracting. Previous work experience using cost accounting principles. Must be able to communicate effectively in English (verbal/written). Details
Seniority level: Mid-Senior level Employment type: Full-time Job function: Finance Industries: Hospitals and Health Care INTEGRIS Health is an Equal Opportunity/Affirmative Action Employer. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.
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Payer Contracting Specialist
role at
INTEGRIS Health
— INTEGRIS Health Corporate Office, Oklahoma’s largest not-for-profit health system, located in Oklahoma City, OK. In this position, you’ll be part of our Payor Strategy team providing exceptional work supporting the INTEGRIS Health caregivers and the community at large. If our mission of partnering with people to live healthier lives speaks to you, apply today and learn more about our recently enhanced benefits package for all eligible caregivers, including front loaded PTO, 100% INTEGRIS Health paid short term disability, increased retirement match, and paid family leave. We strive to be The Most Trusted Partner for Health. Responsibilities
The Payer Contracting Specialist serves as the expert resource and contact for Revenue Integrity contract negotiations and payer analysis. Assists in the administration of payer contracting and financial analysis activities for all INTEGRIS facilities, employed/managed physicians and ancillary services providers. The responsibilities include, but are not limited to, the following (3-5 core functions, approximately 75-80% of time): Maintains contact with Managed Care Organizations, Third Party Administrators, Employer Groups as well as internal staff within INTEGRIS Health. Assists in contract negotiations with payers to obtain the most favorable contract language as well as terms of reimbursement necessary to achieve financial goals. Assists in the design of payer contracting strategies to meet the financial, operational, and strategic needs of the organization. Develops payer statistics through the creation of payer report cards. Facilitates problem solving of operational issues through collaboration with Managed Care Organizations and internal stakeholders. Facilitates, negotiates and coordinates the implementation of single case agreements for facility services as well as securing approval for non-standard reimbursement arrangements. Assists in ensuring compliance with INTEGRIS Health's Legal and Corporate Compliance Departments policies and State and Federal compliance codes. Reports to the System Manager Payer Contracting and Financial Analytics. This position may have additional or varied physical demand and/or respiratory fit test requirements. Please consult the Physical Demands Project SharePoint site or contact Risk Management/Employee Health for additional information. Normal office environment. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status. Qualifications
Bachelors degree in Business or other healthcare related field required; an additional 4 years of related experience may be substituted in lieu of a degree. Masters degree in healthcare, business administration or related field preferred. 3 years experience in managed care contracting. Previous work experience using cost accounting principles. Must be able to communicate effectively in English (verbal/written). Details
Seniority level: Mid-Senior level Employment type: Full-time Job function: Finance Industries: Hospitals and Health Care INTEGRIS Health is an Equal Opportunity/Affirmative Action Employer. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.
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