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International Payer Account Manager
Cleveland Clinic Cleveland, OH
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$92k-126k (estimate)
Full Time | Ancillary Healthcare 1 Week Ago
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Cleveland Clinic is Hiring an International Payer Account Manager Near Cleveland, OH

The International Payer Account Manager role will play a crucial function on the team, working on improving processes across cross-functional teams, reviewing underpayments and contract language terms and conditions with payers, monitoring accounts receivable via monthly meetings and quarterly reporting, helping develop negotiation strategies and report out on contracts post-execution, negotiating single-case agreements with out-of-network payers that drive revenue to the organization, and overseeing all other payer operations issues. The International Payer Account Manager is an instrumental part of international Market & Network Services and will be responsible for the following areas:Accounts Receivable Support• Maintain cross-departmental engagement to support collection efforts• Coordinate Epic rate loads for international payer plans to improve system accuracy• Facilitate payer Service Level Requirements (SLRs)• Maintain cadence of reports and meetings to ensure timely responsesPayer Operations• Quantify administrative expenses saved through streamlined international claims and payment processes• Monitor international insurance policy changes• Act as a liaison between Global Patient Services and international payers• Conduct reimbursement analyses to identify contractual payment discrepancies• Maintain The Insurance Master (TIM) for international plan codes• Manage standard payer communications regarding deadlines, SLRs, rate increases, and facility changesProcess Improvement• Generate routine Accounts Receivable reports highlighting root causes for discrepancies• Propose improvement opportunities• Draft Standard Operating Procedures (SOPs) and ensure compliance within and across departments• Review and analyze effectiveness of newly implemented processesProject Management• Create strategies to enhance payer compliance with Epic rates• Implement new contracts following a process customized for international payers• Lead initiatives that involve conducting discovery and requirements gathering sessions• Support In-Country Representatives (ICRs) in market research• Develop Fact Packs for emerging markets• Support organization and coordination for broker and payer outreach events
Responsibilities:
  • Develops, implements, manages and maintains operational systems and activities.
  • Serves as a liaison with all levels of the organization and outside community.
  • Manages multiple priorities and projects with competing deadlines.
  • Allocates time to meet completion requirements.
  • Serves as a coach and mentor for other positions in the department.
  • Reviews and monitors adherence to Human Resources policies and corporate compliance procedures.
  • Other duties as assigned.

Education:

  • Bachelor's degree in Business Administration, Healthcare Administration or related field.
  • Master’s degree preferred.

Certifications:

  • May be required for specific positions as per policy or regulation.

Complexity of Work:

  • Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
  • Must be able to take appropriate action in a stressful environment.
  • Demonstrated team, leadership, organizational, financial management and problem solving skills.
  • Knowledge of statistical and financial analysis, primary research and business plan development.
  • Strong presentation, communication and training skills required for most positions.

 Work Experience:

  • Minimum of five years of related experience; healthcare setting preferred.
  • Offset: Master’s degree and four years of experience.

Physical Requirements:

  • Ability to communicate and exchange accurate information. 
  • Ability to perform work in a stationary position for extended periods.
  • Ability to work with physical records or operate a computer or other office equipment.
  • In some locations, ability to travel throughout the hospital system.
  • In some locations ability to move up to 25 lbs.

Personal Protective Equipment:

  • Follows Standard Precautions using personal protective equipment as required for procedures.

Pay Range

Minimum hourly: $33.46

Maximum hourly: $51.03

The pay range displayed on this job posting reflects the anticipated range for new hires. While the pay range is displayed as an hourly rate, Cleveland Clinic recruiters will clarify whether the compensation is hourly or salary. A successful candidate's actual compensation will be determined after taking factors into consideration such as the candidate's work history, experience, skill set, and education. This is not inclusive of the value of Cleveland Clinic's benefits package, which includes among other benefits, healthcare/dental/vision and retirement.

Job Summary

JOB TYPE

Full Time

INDUSTRY

Ancillary Healthcare

SALARY

$92k-126k (estimate)

POST DATE

04/25/2024

EXPIRATION DATE

04/27/2024

WEBSITE

my.clevelandclinic.org

HEADQUARTERS

LAKEWOOD, OH

SIZE

15,000 - 50,000

FOUNDED

1921

TYPE

NGO/NPO/NFP/Organization/Association

REVENUE

$10B - $50B

INDUSTRY

Ancillary Healthcare

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About Cleveland Clinic

Cleveland Clinic owns and operates a chain of non-profit hospitals that offers pediatrics, cancer care, surgical and specialty medical services.

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