Position Summary: Provides support to the Manager of Payor Contracting. Primary responsibilities include: obtaining payor contacts and reviewing the agreements, performing fee schedule analysis and determining contract fees, and acts as the point of contact for RCM billing questions.

I. Position Responsibilities: Essential

• Coordinate with Manager of Payor Contracting to develop and implement a network development strategy for existing or new programs. Research payors and complete necessary payor follow-up to obtain agreements and/or linking the location to an existing agreement.
• Summarize the Agreement by completing the contract summary sheet with all the pertinent information from the agreement, which includes gathering Health Plan Contact Information, Credentialing & Enrollment requirements and other pertinent information that is needed by RCM to administer the agreement.
• Fee Schedules: determine if the fee schedule for the plan is appropriate for the state or region that the plan covers. Maintain these fee schedules in ECHO and provide periodic updates. Update fee schedules based on current year annually.
• Makes independent decisions on contracting rates for new agreements and or renegotiated agreements based on existing rate information.
• Link new locations/programs to existing state contracted payors as needed.
• Develop and maintain Echo Reports including rosters, Onboarding Report and Payer lists by state, including coordinating with the vendor when needed.
• Maintain training material for new hires.
• Responsible for maintaining contracting files, including maintenance of the OBHG contracting database.
• Develop and maintain reports and/or spreadsheets to document contracting leads and workflow.
• Be the point of contact when the RCM has issues with any particular Health Plan. Responsible for making independent decisions and coordinating with the Health Plan to assist with resolution of the claims issues.
• Completes other projects as assigned.
• Ensure all Protected Health Information is kept in a secure location at all times.

II. Essential Skills/Credentials/Experience/Education

• Managed Care contracting/provider relations experience in healthcare.
• Bachelor's Degree.
• Strong organizational skills and attention to detail.
• Knowledge of contracting language and the principles of negotiation.
• Familiarity with managed care, State and/or Federal health care programs.
• Strong computer skills, proficient in Word & Excel.
• Strong understanding of credentialing and Managed Care.

III. Mental and Physical Demands (per ADA guidelines)

• Physical Demands:

Sitting for long periods of time. Occupation requires this activity more than 66% of the time (2.6+ hrs/day)

Salary Range: $55,000 - $65,000, based on experience