Manager, Payer Contracts - Remote - Nationwide at Vituity in Sacramento, California

Job Description:

Remote, Nationwide - Seeking Payer Contracts Manager

Everybody Has A Role To Play In Transforming Healthcare

At Vituity you are part of a larger team that is driven by our purpose to improve lives. We are dedicated to transforming healthcare through our culture by working together to tackle healthcare's most pressing challenges from the inside.

Join the Vituity Team. At Vituity we've cultivated an environment where passion thrives, and success comes through shared purpose. We were founded in a culture that values team accomplishments more than individual achievements, an approach we call "culture of brilliance." Together, we leverage our strengths and experiences to make a positive impact in our local communities. We foster this through shared goals and helping our colleagues succeed, and we also understand the importance of recognition, taking the time to show appreciation and gratitude for a job well done.

Vituity Locations: Vituity has opportunities at 475 sites across the country, serving 9 million patients a year. With Vituity, if you ever need to move, you can take your job with you.

The Opportunity

• Responsible for oversight, coordination, and negotiation of contracting activities relating to assigned payer contracts across multiple regions and specialties.
• Makes recommendations regarding contract rates and payer contracting strategy to Director of Payer Contracts and VP of Payer Strategy.
• Manages contract cycle for all assigned agreements with current and prospective payers across multiple regions and specialties. Prioritizes decision making on payer related issues. Analyzes all payer issues and finds a timely solution.
• Determines appropriate language in compliance with established legal requirements and negotiates contract language in a manner consistent with Vituity's policies. Analyzes contractual language for functional, financial, and ethical appropriateness.
• Identifies opportunities to improve financial performance through payer negotiations and communicates the status of payer negotiations to appropriate stakeholders.
• Manages payer negotiation projects which may require research such as new specialties, new states, startups, entity changes, billing company changes, etc.
• Represents Vituity in meetings and negotiations with other organizations, associations, providers, and payers regarding all aspects of payer contracts.
• Acts as subject matter expert on payers and payer reimbursement trends. Maintains high level of expertise regarding payer and reimbursement policies.
• Reviews and assists in contract modeling, proformas, and dashboard reporting. Evaluates utilization and financial impact by region, specialty, and/or payer.
• Consistently demonstrates capacity to manage and resolve urgent issues that arise.
• Provides backup coverage when department Director and/or Sr Manager is unavailable.

Required Experience and Competencies

• Minimum two years of healthcare contracting, or managed care negotiation experience required.
• Minimum five years' experience in healthcare with a thorough understanding of payers contracting, billing and collections, and provider enrollment process required.
• College degree preferred.
• Experience in payer contracting activities including but not limited to negotiation, language review, and resolving disputes.
• Experience in establishing and maintaining strong payer relationships with the ability to research payer related information and obtain requested information timely.
• Ability to effectively interact with all stakeholders both in written and verbal communication.
• Ability to effectively manage time and organize projects to accomplish goals thoroughly and accurately.
• Ability to think critically to evaluate and propose terms as well as solving problems with optimal solution.
• General knowledge of payer policies, coding and reimbursement rules, laws, and regulations.
• General knowledge of legal principles relating to managed care contracting.
• General knowledge of healthcare billing and collection processes to provide appropriate guidance on addressing payer issues.
• Proficient in Microsoft Office Suite (PowerPoint, Word, Excel, Outlook, OneNote, OneDrive, SharePoint, Teams).

The Community

Even when you are working remotely, you are an important part of the Vituity Community. We offer plenty of opportunities to engage with other Vitans through a variety of virtual meet-and-greets, events and seminars.

• Monthly wellness events and programs such as yoga, HIIT classes, and more
• Trainings to help support and advance your professional growth
• Team building activities such as virtual scavenger hunts and holiday celebrations
• Flexible work hours
• Opportunities to attend Vituity community events including LGBTQ+ History, Dia de los Muertos Celebration, Money Management/Money Relationship, and more

Benefits & Beyond*

Vituity cares about the whole you. With our comprehensive compensation and benefits package, we are mindful of what matters most, and support your needs of today and your plans for the future.

• Superior health plan options
• Dental, Vision, HSA/FSA, Life and AD&D coverage, and more
• Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6%
• Outstanding Paid Time Off: 3-4 weeks' vacation, Paid holidays, Sabbatical
• Student Loan Refinancing Discounts
• Professional and Career Development Program
• EAP, travel assistance, and identify theft included
• Wellness program
• Vituity community initiatives including LGBTQ+ History, Dia de los Muertos Celebration, Money Management/Money Relationship, and more
• Purpose-driven culture focused on improving the lives of our patients, communities, and employees

We are excited to share the base salary range for this position is $85,170 - $106,465, exclusive of fringe benefits or potential bonuses. This position is also eligible to participate in our annual corporate Success Sharing bonus program, which is based on the company's annual performance. If you are hired at Vituity, your final base salary compensation will be determined based on factors such as skills, education, and/or experience. We believe in the importance of pay equity and consider internal equity of our current team members as a part of any final offer. Please speak with a recruiter for more details.

We are unified around the common purpose of transforming healthcare to improve lives and we believe everyone has a role to play in that. When we work together across sites and specialties as an integrated healthcare team, we exceed the expectations of our patients and the hospitals and clinics we work in. If you are looking to make a difference, from clinical to corporate, Vituity is the place to do it. Come grow with us.

Vituity appreciates differences; our dedication to diversity, equity and inclusion is at the heart of our organization. Vituity does not discriminate against any person on the basis of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information (including family medical history), veteran status, marital status, pregnancy or related condition, or any other basis protected by law. Vituity is committed to complying with all applicable national, state and local laws pertaining to nondiscrimination and equal opportunity.

*Benefits for part-time and per diem vary. Please speak to a recruiter for more information.

Applicants only. No agencies please.