Payor Performance Analyst Jobs

Gain experience in managing multiple facilities'/payers' enrollment requirements

Process applications for insurance payer participation and manage enrollment requirements

Perform other duties assigned by the Payer Enrollment Manager and/or Management

Knowledge of clerical principles and strong telephone etiquette

Strong organizational skills and attention to detail

High School Diploma or equivalent required; some college or equivalent experience preferred

Program or Project Management Certification

You're not someone who works off assumptions. Our Technical Program Management Department always seeks to understand and works to confirm assumptions.

You are outstanding at air traffic control – demonstrable abilities in juggling multiple balls at once, comfortably.

Experience in a fast-paced startup environment

If you don’t meet 100% of the below qualifications, you should still consider applying.

You are ambitious – you are always seeking to understand and continuously learn while identifying ways to grow.

Retain clients by rematching those who had an unfavorable experience

Meet with manager to discuss QA, accept feedback and improve communications

You are successful working independently and remotely, and adapt well to changing priorities and customer needs

Bonus points if you have a track record of at least one year of successful customer-facing professional experience

Our dedication to mental health guides our culture. Wellness benefits include (but are not limited to):

Flexible working hours and location (remote OR in-office, your choice!)

High school diploma required; equivalent combination of education and experience will be considered

Has basic skills and knowledge to perform routine tasks.

Collaborates with worldwide resources to ensure effective knowledge, information sharing, and quick resolution of service performance issues.

Minimum of 2 years of DME billing or accounts receivable experience required. Preferably well versed in Medicare guidelines and reimbursements.

Minimum of 2 years of experience working in & maintaining HIPAA standards

Highly skilled in using computers & Microsoft products (Excel and Word) is required.

3-5 years of prior experience in a managed care contract management role required.

Oversee organizational contract development and management activities and enforce organizational principles of integrity and compliance.

Conduct contract strategy meetings to identity issues, facilitate pricing discussions, and obtain senior management input on timelines and deliverables.

Draft contractual provisions based on strategy discussions, senior management input, and organizational needs and expectations.

Bachelor's Degree in Business, Healthcare Management, or related field preferred. Advanced degree desirable.

Prior experience in a supervisory role, with the demonstrated ability to train and develop staff, applying applicable knowledge and experience.

High school diploma required; equivalent combination of education and experience will be considered

Let’s talk about Qualifications and Experience

Key accountabilities and decision ownership:

Collaborates with worldwide resources to ensure effective knowledge, information sharing, and quick resolution of service performance issues.

Other tasks and responsibilities as assigned

Minimum of 2 years of home infusion billing or accounts receivable experience required

Any combination of education and experience, which would provide an equivalent background

Health or managed care experience

Requires a BA/BS degree in a related field and a minimum of 2 years of related experience(Or)

Strong strategic managed care understanding for Medicare Advantage, Medicaid, Commercial and chronic complex populations

Extensive knowledge of CMS, NCQA regulatory guidelines

Exceptional communication skills (verbal and written) and executive presence

Role responsibilities include, but are not limited to:

· Bachelors degree with 6 years of relevant healthcare industry Sales experience, specifically SaaS

· Represent at conferences and other relevant industry events

· Collaborate with marketing, product, and strategy teams to ensure that priorities aligned

Our ideal candidate will have:

· Willingness to travel 25%+

Education: Bachelor’s degree, required. Bachelor’s Degree in Mathematics, Accounting, Finance, Economics Health Care Administration or related field. Master’s degree, preferred.

Conducting thorough analysis of internal and external factors surrounding Payor Programs as well as ongoing proposal development and evaluation

Building one-off financial projections, decision support models and financial reporting for evolving new products, performance programs, risk models and other initiatives

Assessing competitive pricing and value based care position utilizing varying data sources

Providing support for various multi-disciplinary projects in support of NH pricing strategy, strategic imperatives and revenue cycle activities

Evaluating healthcare total cost of care risk and opportunities for populations