Mount Sinai Medical Center New York , NY 10007
Posted 4 weeks ago
Description Responsible for providing leadership, direction, management of Contract Negotiations and Enforcement. That the operations and objectives of the Health Systems Managed Care Contracting objectives and goals are achieved.
Responsibilities Directs, supervises, and coordinates negotiations with Managed Care Organizations to assure contracting with Managed Care Organizations is meeting financial, practice, operational standards established by MSHS and the Third-Party Contract. Contributes to the development of division's strategic mission, goals, policies and procedures, budget, work standards in coordination with the Senior Vice President, Vice President and Assistant Vice President.
Contributes and develops strategic action plans to increase revenue through contracting, managed care payer relationships, strategic business development and contract oversight.
Develop, implement, and oversee strategic business relationships internally. Oversight and manage relationships with key stake holders within Managed Care Organizations.
Works directly with Contract Compliance and Enforcement to assure contract compliance internally and externally.
Works with Contract Compliance and Enforcement to assure Managed Care Organizations, Third Party Payers and other contracted organizations are operating in compliance with the contract. Works with internal stake holders to reduce lost revenue associated with contractual non-compliance.
Assures timely notification, tracking, resolution and compliance with contractual dispute resolution processes, including working with internal and external legal counterparts.
Develop and assist in the selection, employment, development, and management of employees. Responsible for personnel policies and practices.
Provides oversight of the performance appraisal process, disciplinary action, and interactions with all applicable bargaining units.
Attends administrative labor grievances as requested. Ensures the development and delivery of required staff training using a competency-based assessment program.
Evaluate and develop staff based on job-specific competencies.
Evaluates how staff resources are allocated to support business activities and revenue cycle initiatives. Interacts with medical and administrative staff to ensure compliance with standards and regulations, to include The Joint Commission and NYS/NYC Department of Health.
Reviews and interprets operational problems/policies to practice managers.
Resolves problems and recommends changes to senior leadership. Works collaboratively with other departments regarding annual operating and capital budgets.
Contributes to capital selection process to ensure purchases support operations and growth.
Coordinates with the Health Information Management department on medical records management, release, and facilitation of information. Collaborates with leadership of Patient Financial Services on revenue cycle initiatives and operational processes with a financial impact.
Evaluate the effectiveness and support of information technology applications to support operations.
Oversees Quality Assurance program that supports and contributes to the key elements of operational practice, including, but not limited to, financial performance indicators and patients access to the system. Represents the department at public and professional meetings and conferences as requested.
Facilitates communication and ensures proper flow of information.
Participates in public relations programs. Coordinates, as requested, operational committees and physician advisory committees.
Collects data, prepares reports, analyzes statistics, and responds to correspondence in a timely manner.
Supports institutional Studer/Patient Satisfaction initiative to enhance organizational performance. Demonstrates professional behavior reflective of leadership best practices.
Maintains professional affiliations and enhances professional development to keep pace with health care trends.
Handles special projects assigned by the SVCP and/or VP of Managed Care. Maintains strict confidentiality. Qualifications Bachelor's Degree preferred or 15 to 20 years combined experience negotiating provider and third party payer contracts. Excellent written and oral communication skills Exceptional attention to detail and accuracy Analytical and problem solving skills Managerial skills including budgeting and finance Non-Bargaining Unit, E01 - Partner MSO Services
Bachelor's Degree preferred or 15 to 20 years combined experience negotiating provider and third party payer contracts. Excellent written and oral communication skills Exceptional attention to detail and accuracy Analytical and problem solving skills Managerial skills including budgeting and finance Non-Bargaining Unit, E01 - Partner MSO Services
Directs, supervises, and coordinates negotiations with Managed Care Organizations to assure contracting with Managed Care Organizations is meeting financial, practice, operational standards established by MSHS and the Third-Party Contract. Contributes to the development of division's strategic mission, goals, policies and procedures, budget, work standards in coordination with the Senior Vice President, Vice President and Assistant Vice President.
Contributes and develops strategic action plans to increase revenue through contracting, managed care payer relationships, strategic business development and contract oversight.
Develop, implement, and oversee strategic business relationships internally. Oversight and manage relationships with key stake holders within Managed Care Organizations.
Works directly with Contract Compliance and Enforcement to assure contract compliance internally and externally.
Works with Contract Compliance and Enforcement to assure Managed Care Organizations, Third Party Payers and other contracted organizations are operating in compliance with the contract. Works with internal stake holders to reduce lost revenue associated with contractual non-compliance.
Assures timely notification, tracking, resolution and compliance with contractual dispute resolution processes, including working with internal and external legal counterparts.
Develop and assist in the selection, employment, development, and management of employees. Responsible for personnel policies and practices.
Provides oversight of the performance appraisal process, disciplinary action, and interactions with all applicable bargaining units.
Attends administrative labor grievances as requested. Ensures the development and delivery of required staff training using a competency-based assessment program.
Evaluate and develop staff based on job-specific competencies.
Evaluates how staff resources are allocated to support business activities and revenue cycle initiatives. Interacts with medical and administrative staff to ensure compliance with standards and regulations, to include The Joint Commission and NYS/NYC Department of Health.
Reviews and interprets operational problems/policies to practice managers.
Resolves problems and recommends changes to senior leadership. Works collaboratively with other departments regarding annual operating and capital budgets.
Contributes to capital selection process to ensure purchases support operations and growth.
Coordinates with the Health Information Management department on medical records management, release, and facilitation of information. Collaborates with leadership of Patient Financial Services on revenue cycle initiatives and operational processes with a financial impact.
Evaluate the effectiveness and support of information technology applications to support operations.
Oversees Quality Assurance program that supports and contributes to the key elements of operational practice, including, but not limited to, financial performance indicators and patients access to the system. Represents the department at public and professional meetings and conferences as requested.
Facilitates communication and ensures proper flow of information.
Participates in public relations programs. Coordinates, as requested, operational committees and physician advisory committees.
Collects data, prepares reports, analyzes statistics, and responds to correspondence in a timely manner.
Supports institutional Studer/Patient Satisfaction initiative to enhance organizational performance. Demonstrates professional behavior reflective of leadership best practices.
Maintains professional affiliations and enhances professional development to keep pace with health care trends.
Handles special projects assigned by the SVCP and/or VP of Managed Care. Maintains strict confidentiality.
Mount Sinai Medical Center