Payer Performance Manager

 About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. 

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.

JOB SUMMARY:

The Payer Performance Manager will have healthcare data analytics, informatics and a healthcare revenue cycle background. This role will assist CorroHealth clients in ensuring that payers are paying according to their contract guidelines. This role will also include payer denial analysis, trending and report building. The Payer Performance Manager will work with all areas of Revenue Cycle to ensure reimbursement for the hospital. The analyst will be required to produce weekly reporting on weekly financials and payer issues as well as manage all the payer meetings, including creating the payer agenda, reporting claim issues and working directly with payer representatives for claim resolution. The Analyst will work with CorroHealth proprietary tools to analyze large volumes of hospital data. The role will require various technical data manipulation techniques to analyze large complex data sets, identify data patterns, data mine, etc. Candidates must communicate data trends to Revenue Cycle Leadership as well as Payer Representatives.

ESSENTIAL DUTIES AND RESPONSIBILITIES: 
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

ESSENTIAL JOB FUNCTIONS:

Audit, Analysis and Strategy

Analyze large volumes of hospital data and weekly/monthly reporting

Employ various techniques to analyze large complex data sets

• Data manipulation
• Dana mining
• Identifying data patterns

Weekly Revenue Cycle and Payer Reporting

Communications

• Payer Meetings- (Contracted Insurance Carriers)
• Preparing meeting agenda
• Running Payer meetings
• Following up for any action items related to payer meetings

EDUCATION: Some college or equivalent experience, area of study may include:

• Business, Informatics, Data Analytics
• Finance, Accounting, or a related field

EXPERIENCE:

• 3+ years working with data in a healthcare environment
• 2+ years working with Government and Commercial payers or equivalent years of experience with payer contracting
• Advanced level proficiency with Microsoft Excel required.

OTHER HELPFUL EDUCATION OR EXPERIENCE

• Meditech or other EMR experience preferred
• Bachelor’s Degree Preferred
• SQL or other database software experience preferred

KNOWLEDGE, SKILLS and ABILITIES

• Acute attention to detail and strong analytical skills (required)
• Strong understanding of Revenue Cycle, Commercial and Government Payers
• Strong written and verbal communication skills
• Ability to employ critical thinking skills and work independently while also working well within a team environment
• Receptiveness to differing views and ideas with the ability to apply industry-specific concepts
• Highly adaptable to changing circumstances and/or directives in day-to-day priorities
• Ability to perform well on frequent repetitive tasks while continually improving skills and competencies
• Comfortable in faced paced working environment
• Ability to manage and complete short- and long-term projects
• Ability to set and meet deadlines
• Willingness to travel occasionally

PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.