| EOE Statement:|
Washington University is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity or expression, national origin, genetic information, disability, or protected veteran status.
This position is full-time and works approximately 40 hours per week.
Department Name/Job Location:
This position is in the WU Physicians Network. This position is for the Medical School Campus.
Review, analyze, negotiate, and manage the managed care contracts presented to, or held by Washington University School of Medicine (WUSM). Includes negotiation of contract language and reimbursement terms. Provide support to WUSM Department staff and Washington University Clinical Associate practices on all matters related to WUSM’s managed care contracts and payer relationships
PRIMARY DUTIES AND RESPONSIBILITIES:
- Assist Senior Director, Managed Care in review, financial analysis, negotiation and management of all managed care contracts. Objective is to maximize WUSM revenues while minimizing WUSM administrative cost or loses.
- Negotiation and management of all Single Patient Agreements (SPAs) on behalf of WUSM. Includes coordination of all such arrangements with health insurance staff and appropriate affiliated hospital staff.
- Represent WUSM interest in its relationships with health insurance plans, government agencies or their representatives, and affiliated hospitals. An important role in increasing department insight and overall understanding of information and issues vital to department success. Gather information necessary for department planning and development of department strategy. Coordinate internal communications related to compliance with managed care agreements.
- Responsible for general problem resolution related to management of managed care contracts. Includes contract interpretation and advocating for solutions to reimbursement or administrative conflicts with health insurance company staff.
- Primary department support to WUPN community physician practices as well as the physician practices of Washington University Clinical Associates. Includes orientation/ education of practice staff/ physicians with respect to WUSM managed care contracts.
- Assist the Director of Credentialing and Managed Care Contracting in negotiation and management of all care-out agreements (includes organ transplant, mental health, etc.).
- Maintain WUSM Managed Care contract related resources. Includes reimbursement grids, contract profile grids, assisting in maintenance of Referring Physician database.
- Performs other duties as assigned.
Bachelor’s Degree and/or 3+ years’ experience in managed care, or closely related field. Contracting and/or Provider Relations experience.
- Bachelor’s degree.
- 5+ years’ experience in managed care or closely related field.
- Working knowledge of database, spreadsheet and word processing software.
- Financial analysis experience preferred.
- Effective verbal, written and interpersonal communication skills.
The hiring range for this position is $53,206 - $69,160 annually.
-Retirement Savings Plan
-22 vacation days
-8 Paid Holidays
-Tuition benefits for employee, spouse and dependent children
-Free Metro Link/ Bus pass
-Free Life Insurance
-Health, Dental, Vision
-Health Savings Accounts (HSA)
-Long Term Disability Insurance
-Flex Spending Plan
Med School HR website (medschoolhr.wustl.edu)
Internal Applicant Instruction:
This position is grade G12.
Please attach a copy of your most current signed performance evaluation (completed within the last 18 months) to your online account. If you have not received a performance evaluation, you may provide two current signed letters of recommendation (written within the last 18 months), preferably to include one letter from either a current or recent former supervisor. To attach these documents, go to: My Career Tools, Add Attachment, Attachment Type – Performance Reviews or Letters of Recommendation.