Job Information

AdventHealth Manager Revenue Management Managed Care in Maitland, Florida

Description

Manager Revenue Management Managed Care | AdventHealth Corporate

Location Address: 2600 Lucien Way Maitland, FL 32751

Top Reasons To Work At AdventHealth Corporate

  • Great benefits

  • Immediate Health Insurance Coverage

  • Career growth and advancement potential

Work Hours/Shift:

  • Full-Time, Monday - Friday

You Will Be Responsible For:

  • Responsible for securing provider effective dates with commercial and government payers as well as directing reimbursement analyst team to identify payment variances for professional fee commercial contracts and government payers.

  • Supports PE with securing missing provider effective dates and payment variance identification and liaisons with payer as needed to collaborate on resolution.

  • Screens, interviews, and hires qualified applicants for open positions.

  • Evaluates performance of immediate subordinates and makes recommendations for personnel actions.

  • Performs personnel management activities, including merit increases, promotions, transfers, and disciplinary actions.

  • Determines training and development programs for support staff and arranges such opportunities.

  • Closely works with MC enrollment, credentialing, contract administration to ensure effective dates are secured and loaded contracts are accurate and updated as required.

  • Maintain a working knowledge of current rules and regulations of Commercial and Government programs.

  • Oversees the review of missing provider effective dates and all manual contractual adjustments to determine cause, reducing future incidence by addressing training and procedural variances and bringing focus to bear on true underpayments for quick resolution.

  • Serve as AdventHealth’s subject matter resource for Commercial and Government payment variance identification, and education.

  • Meets with PE and MC management teams as required to provide monthly updates on current variance projects, future initiatives and specific payer issues.

  • Supplies analytical data to MC and PE leadership as needed.

  • Coordinates with billing support teams to provide guidance and education pertaining to effective date management and identified payment variances.

  • Completes special projects as assigned by the department director within the time frame requested.

  • Mentors direct reports

Qualifications

What You Will Need:

  • Bachelor’s Degree in Healthcare, Business Administration, or related field

  • Minimum of 7 years of relevant experience in healthcare reimbursement including Commercial and Government payers

  • 5 years of managerial experience

Job Summary:

Responsible for securing provider effective dates with commercial and government payers as well as directing reimbursement analysts who perform the work of evaluating professional fee contractual adjustments for accuracy in accordance with various payer contracts and/or federally mandated guidelines. This position oversees the payer follow-up and data entry of provider effective dates and payment variance identification for Managed Care (MC) on behalf of the Physician Enterprise (PE) and works closely with practice office operations staff, MC enrollment, credentialing, contracting and billing support teams to identify and recommend corrective action on securing effective dates and payment variances.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Category: Managed Care

Organization: AdventHealth Corporate

Schedule: Full-time

Shift: 1 - Day

Travel: AdventHealth

Req ID: 22001875

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.