Job Information

University of Utah Health Manager, Health Plans Provider Contracting in Murray, Utah

Overview

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, diversity, integrity, quality and trust that are integral to our mission. EO/AA

Under the direction of the Provider Network Director, the Manager of Provider Contracting is responsible for negotiation and renegotiation of provider contracts as well as ongoing evaluation, administration and monitoring of managed care and governmental payer agreements for facility, professional and ancillary services. The responsibilities are to perform contract development and negotiation/renegotiation to develop contracts that support the triple aim, are operationally and financially successful for the company, and support a stable and financial level of reimbursement in collaboration with our provider partners. This position monitors network adequacy and network performance. This position will work closely with all departments and providers throughout the state. The Manager of Provider Contracting must be highly collaborative and relationship oriented with a commitment to ACO concepts and goals.

Corporate Overview: University of Utah Healthcare is an integrated academic healthcare system with four hospitals including a level 1 trauma center, twelve community health centers, over 1,600 providers, and a health plan serving over 200,000 members. University Healthcare is nationally ranked and recognized for our academic research, quality standards and overall patient experience. In addition to our clinical delivery system, we have a School of Medicine, School of Dentistry, College of Nursing, College of Pharmacy, and College of Health providing education and training for over 1,250 providers annually. We have over 2 million patient visits annually and research grants exceeding $350 million.

Responsibilities

Job Specific Responsibilities and Accountabilities

  • Performs to required standards for job specific responsibilities and technical competencies.

Talent Management

  • Hiring, training, developing, and communicating with staff.

Financial Management

  • Responsible for developing, monitoring and achieving budget goals.

  • Manages labor and non-labor expenses to budget or flex budget.

  • Manages revenue to budget to maximize potential revenue.

EPE/Service

  • Responsible for patient satisfaction scores within assigned area(s).

  • Responsible for upholding PROMISE standards of direct reports and team members.

Quality

  • Responsible to achieve quality goals for assigned area(s).

  • Manages and promotes continuous process improvements in assigned area(s).

Performance Management

  • Responsible to provide staff feedback on performance, including on-time appraisals and coaching.

  • Responsible to deal with conflicts in a proactive manner and to reach resolution in a timely manner.

Building Relationships

  • Forms positive relationships with staff, peers, and senior leadership to support the mission, vision, values, and performance standards of the organization.

  • Actively engages staff with updates and news as well as involving staff in decisions and work teams. Provides feedback and recognition when appropriate.

Knowledge / Skills / Abilities

  • Knowledge of principles and processes of hospital, physician and managed care billing practices and reimbursement methodologies.

  • Demonstrated skills in contract negotiations including difficult and complex negotiations.

  • Ability to establish credibility and develop collaborative relationships with hospitals, physicians, and ancillary providers.

  • Ability to supervise, train and mentor staff and communicate effectively with staff, management, executives, and physicians.

  • Strong organization, time management and project management skills and multi-tasking abilities.

  • Advanced analytical skills and problem solving skills with the ability to formulate and communicate recommendations for improvement.

  • Knowledge and application of English grammar including composition, editing and proofreading skills.

  • Detail oriented.

  • Knowledge of and experience with Medicaid and Medicare insurance programs.

  • Knowledge of the Utah health community, including public and private entities and their role in the provision of health care to Utah residents.

  • Knowledge of appropriate local, state, and federal regulations.

  • Ability to work effectively, independently, and as part of a team.

  • Demonstrated computer skills (including Excel, Word).

Qualifications

Qualifications Required

  • A Bachelor's degree or equivalent related healthcare experience.

  • A minimum of 5 years related healthcare experience in provider or payer relations, provider or payer reimbursement, and/or managed care contracting.

Qualifications (Preferred)

Preferred

  • Previous management experience.

  • Working knowledge of provider contract configuration related to accurate claims payment that reflects the provider agreement and intent.

  • Experience with Epic as the provider fee schedule and claims payment system.

  • Master's degree in Health Care Administration, Business Administration, or related area.

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

  • This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

Physical Requirements

Listening, Sitting, Speaking, Standing

EEO Statement

The University of Utah Health Care is an Affirmative Action/Equal Opportunity employer. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities. The University of Utah Health Care is committed to diversity in its workforce. Women and minorities are encouraged to apply.

Requisition Number 48670
Reg/Temp Regular
Employment Type Full-Time
Shift Day
Work Schedule Days
Location Name University of Utah Health Plans
Patient Care? No
City Murray
State UT
Department UIP CST 01H UUHP PROVIDER SRVC
Category Insurance / Health Plans

The University of Utah Health Care is an Affirmative Action/Equal Opportunity employer. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities. The University of Utah Health Care is committed to diversity in its workforce. Women and minorities are encouraged to apply.