Payor Operations & Analytics Manager

Job description

Newport News, Virginia Overview: Assists with the development, strategic planning, and execution of managed care contracts for hospitals, medical groups, and ancillary providers. Provides enterprise level planning, development, implementation, and management of contractual relationships with payers; including accountable care organizations. Responsible for managing analytics readiness (integrity of modeling systems, payer trending, etc.) and financial analysis related to payer negotiations. Facilitates constructive payer relationships, coordinates operational changes to improve efficiency, identifies issues and initiates problem resolution. What you will do: - Manages daily operations of the Payer Relations team to include credentialing, issue resolution, research, payer monitoring, revenue integrity, contract maintenance, education, and communication to operational areas, quality, service lines, and IT for reimbursement, payer policies, and value based programs. Provides coaching and development for analysts. - Plans, develops, implements and manages contractual relationships with payers to include ACOs. - Responsible for analytics readiness. Manages the payer analytics team durin...