Shriners Childrens is a family that respects, supports, and values each other. We are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience defines us as leaders in pediatric specialty care for our children and their families.

This position will be responsible for continuously exemplifying the mission, vision, values, and customer service philosophy of SHC in job performance and in service to other persons and customers both internally and externally. This position is responsible for maintaining and updating contract management system. This position is also responsible for understanding any technology applications utilized to manage contract rates vs. payments (e.g. Variance Tools). This position will also assist in working with the Payor Relations team, revenue cycle department, provider enrollment, and others to resolve any major claims related issues in a timely manner. The position is also responsible for assisting in renewal and negotiations of third-party pay agreements, credentialing, supporting in-service orientations, and site visits. Work collaboratively and closely with management, executives, hospitals, staff, and leadership to ensure effective management and use of third-party pay relationships.

• Facilitate and maintain third-party pay contract relationships
• Supports developing and maintaining external third-party pay and other related provider and Plan contractual relationships to support the current and future strategic financial goals, mission, vision, and values.
• Responsible for Contract Management Systems, language analysis tools, and related repositories.
• Responsible for assisting in proactively planning and prioritizing third-party pay negotiations to support the system, facilities, and market growth and development.
• Leads the coordination with various internal departments, e.g., Revenue Cycle Department, Legal Department, Provider Enrollment and other internal and external departments as applicable to ensure timely facility credentialing, and resolution of significant third-party payor related issues/claims.

Required:

• 5 years healthcare experience
• 3 years managed care and health system setting with contractual negotiations experience
• 3 years managed care & health system contractual terms and reimbursement methodologies