E00198 - Contracts Payor Manager

Position Overview:

Superstar National Payer Manager to obtain in-network contracts with the major health insurers across the United States including United Healthcare, Aetna, Cigna and the many Blue Cross/Blue Shield Operations covering the United States.

Genetworx and Recovery Centers of America, two of the fastest growing healthcare companies in the world, are seeking a National Payer Manager to obtain in-network contracts across the United States with major insurance companies and managed care companies. These companies are in the drug and alcohol rehabilitation and lab businesses.

Specific Responsibilities:

• Contract with major health insurance companies and managed care plans across the United States for Genetworx and Recovery Centers of America.

• Manage ongoing relationships with these companies and plans.

• Maintain up-to-date information for efficient billing and product offering.

• Monitor all aspects of the payer relationships to insure appropriate and efficient communication contract compliance and issue resolution.

• Work closely with credentialing to identify and remove revenue cycle barriers.

• Participate in language review and reimbursement analysis.

• Achieve favorable medical coverage policy and reimbursement agreements with private payers.

Education and Experience:

• Advanced skills in MS Word, PowerPoint, Outlook, and Excel.

• 7+ years of industry or related work experience

• Solid mathematical aptitude and effective project management skills.

• Ability to analyze and document complex business processes.

• Must possess strong understanding of the local behavioral healthcare managed care environment, including, but not limited to, managed care policies and procedures, reimbursements mechanisms, and practice management/medical office procedures

• Experience with Managed Care contracting for Laboratories and Medication Assisted Treatment Centers is preferred.

• Ability to build and maintain positive relationships on all levels within the organization, managed care companies, and other affiliated partners.

Competencies:

Customer Service: Demonstrates concern for meeting internal and external customers' needs in a manger that provides satisfaction for the customer within the resources that can be made available.

Impact and Influence: Works effectively with and through others including those whom there is no formal authority over.

Project Management: Coordinates the diverse components of the project by balancing scope, time, cost, and quality.

Communication: Communicates well both verbally and in writing, creates accurate and punctual reports, delivers presentations, shares information and ideas with others, has good listening skills.

Work Environment: May work in a variety of environments including professional offices, clinics, hospitals, or out-patient facilities. They spend much of their time on their feet, actively working with patients.

Physical Demands: While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands to finger, handle or feel objects, tools or controls. The employee is occasionally required to stand; walk; sit; reach with hands and arms; climb or balance; and stoop, kneel, crouch or crawl. The employee must occasionally lift and/or move objects up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, color vision, peripheral vision and the ability to adjust focus.

Travel: Travel is primarily local during the business day, although some out-of-the-area and overnight travel may be expected