Net Revenue Manager

ChristianaCare is searching for a Net Revenue Manager to play a critical role in advancing Epic payer contract modeling, which will support the organization in financial decisions related to payer contract negotiations and impact of imposed payer policies. This role will have responsibilities for the review and analysis of data related to projects where net revenue neutrality needs to be maintained. Additionally, this position oversees Epic payer plan committee, payer plan maintenance and transactional mapping for Epic-to-Workday financial interfaces.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Payer Contract Modeling, Reporting and Analytics:

Develop and maintain contract models using Epic's contract modeling tool, analyze impact of DRG updates, payer policies, and repricing activities.

Evaluate contract proposals and support payer negotiation strategies through modeling and monetary impact analysis.

Design and produce contract variance reports, net-to-gross analyses, and other analytics to support Finance, Revenue Cycle and Managed Care teams.

Identify and analyze overpayment/underpayment patterns, escalating systemic payer issues as needed.

Maintain client billing contracts and conduct periodic rate reviews; track and follow up on required updates with stakeholders.

Net Revenue Neutrality:

Support net revenue neutrality projects, including review of vendor work related to pricing and charging methodology changes.

Assist in annual CDM pricing updates, working with Revenue Integrity, price transparency vendor, and finance to provide for timely and accurate gross revenue budgets by department.

Coordinate periodic charge reviews - especially for physician billing - to prevent revenue leakage and ensure compliance with payer contract "lesser of" rules.

Payer Plan Administration:

Lead Payer Plan Committee meetings and ensure alignment across hospital and professional billing, payer reimbursement, and managed care teams.

Maintain Epic payer plan insurance table, including setup, change control, mapping, and inactivation of plan codes.

Maintain accuracy and consistency for payer plan and all transactional mapping for Epic-to-Workday financial interfaces.

Cross-Functional Collaboration:

Communicate and collaborate regularly with managers, IT, Finance and Revenue Cycle teams to share updates and resolve outstanding issues.

Assist as needed in updating and maintaining contracts within Experian's Price Estimator tool, including testing system for accuracy of patient estimates.

EDUCATION AND EXPERIENCE REQUIREMENTS:

• Bachelor's degree - Accounting or Finance
• Five to seven years of experience in healthcare finance preferred.
• Knowledge of healthcare reimbursement, patient accounting and contract management preferred, as well as confidence in working with substantial amounts of data.
• Contract management systems and/or Epic experience required

Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

Post End Date

EEO Posting Statement

ChristianaCare offers a competitive suite of employee benefits to maximize the wellness of you and your family, including health insurance, paid time off, retirement, an employee assistance program. To learn more about our benefits for eligible positions visithttps://careers.christianacare.org/benefits-compensation/