1438 Qc Supervisor jobs in Dickson,TN

New, Posted 3 hours ago

Manager of Managed Care Operations - Hybrid / Remote

Surgery Partners

Nashville, TN 37219

RemoteHealth InsurancePaid Time OffRetirement Benefit

Bachelors degree required in business, technology or healthcare related field
Minimum of 3 years of experience in managed care environment
2+ years of negotiation or provider relations experience between providers and major commercial payors in markets in the U.S. and or experience in contract analysis for ASC services.
Experience with ASC reimbursement methodologies.
Experience working with payors and billing office staff to resolve payment discrepancies.
Reasonable understanding of healthcare CPT coding and billing.
Excellent quantitative and analytical skills, with attention to detail to ensure that modeling for negotiations is accurate.
Moderate knowledge of Excel and/or ability to expand knowledge quickly.
Solid understanding of payer contract reimbursement methodologies and application of payor policies on reimbursement expected under existing and future agreements.
Strong writing skills and ability to communicate effectively in order to negotiate key terms of payor agreements.
Understanding of healthcare industry trends in payor negotiations including contract language, product development trends, pay for performance programs, bundled payment programs, etc.
Understanding of provider reimbursement methodologies from Medicare, and knowledge of how Medicare reimbursement is updated from time to time.
Must be self-motivated and able to work independently. Inquisitive nature and interest in sharing knowledge among team members.
Must be able to provide timely written and verbal communication of complex negotiations to internal leadership.
Experience managing multiple projects and negotiations with varying teams and deadlines.
Strong communication skills necessary.
Team orientation toward success.
Physical Requirements Occasionally 0 – 33% Frequently 34 – 66% Constant 67 – 100%
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