Payer Contracting Manager - Payer Rate Development and Payer Performance Reporting

Job Description:

The Payer Contracting Manager of Payer Rate Development and Payer Performance Reporting produces analytical solutions (modeling, reports, dashboards, tools, etc.) for leadership and stakeholders across the organization that supports business or clinical initiatives. In addition, the manager provides consultation and support in the development, analysis, interpretation, and management of a variety of highly complex data sources to support process improvement, operations, revenue growth and integrity, strategy, cost reduction, and increased patient safety and satisfaction.

Along with offering a chance to work in a stable, strong, mission-based environment, this role provides the opportunity to experience the Mountain West’s diverse culture and incredible landscapes. You’ll be able to explore abundant outdoor recreational opportunities, including skiing, hiking, and fishing, as well as stunning national parks and forests, all within hours of where you’ll call home. Becoming a part of the Intermountain team means gaining a family and finding a place to plant your roots. 

Benefits are one of the ways we encourage health for you and your family. Our generous package includes medical, dental, and vision coverage. But health is more than a well-working body: it encompasses body, mind, and spiritual well-being. To that end, we’ve launched a Healthy Living program to address your holistic health. Healthy Living includes financial incentives, digital tools, tobacco cessation, classes, counseling, and paid time off. We also offer financial wellness tools and retirement planning. 

With this position, you are eligible to participate in an annual pay-for-performance opportunity (“AP4P”). This plan enables Intermountain Health to provide leaders with an additional performance compensation opportunity. The AP4P opportunities are calculated as a percentage of your base salary. Awards are paid out based on attainment of selected Intermountain Health Board-approved goals. 

The qualified candidate must live in the State of Utah and will then work in a mostly remote capacity.

As the Payer Contracting Manager of Payer Rate Development and Payer Performance Reporting, you will:

• Lead payer payment rate modeling using Epic and other related tools for all Intermountain Health regions.  This requires attention to applying data and ad hoc scenarios to detailed payment methodologies, historical data and projected changes with results that are vital to the financial success and revenue growth for Intermountain Health (>$1 billion).

• Be accountable for timely and accurate reports as requested by leadership and stakeholders across the organization that support business and clinical initiatives.

• Create payer performance reports that answer multiple related questions as well as reports with linked content, drilldown, and nested parameters. The reports are formatted in such a way that leads the user through the report in a well-organized, easy to understand fashion.

• Use standard Intermountain reporting tools to generate reports for end users that interpret data for others to promote evidence-based decision making.

• Compare data output to ensure data accuracy and create basic QA test plans and validates data for accuracy and is responsible for documenting work / projects per enterprise-wide standards (reports, project tracking, databases, etc.).

• Support contract negotiations and contract implementation by being a content expert for payer contract rates and methodologies, and developing new payment models. 

• Support Payer Contracting in writing and reviewing contract language, supporting the process for Epic contract builds, and making recommendations as appropriate to department management. Such support may require working directly with Epic to identify or develop a solution.

• Oversee and coordinate the communication and messaging to internal parties of new contract rates and terms, rate structure and payment methodologies to ensure alignment and accurate programming of contract builds.

• Provide project management / project leadership as appropriate to drive timelines and deliverables.

• Supervise supporting contract analysts.

Skills

• Leadership

• Accountability

• Quality Improvement

• Analytical Thinking

• Group Problem Solving

• Project Planning

• Communication

• Professional Etiquette

• Taking Initiative

• Work Collaboratively

Minimum Qualifications

• Bachelor’s Degree with five years of analytics experience. Degree must be obtained through an accredited institution. Education is verified.

• Demonstrated proficiency and an advanced working knowledge of MS Excel, Strata, Epic, and other tools, applying quality improvement principles, and a solid knowledge of database design principles.

• Demonstrated experience in developing, analyzing, interpreting, and managing a variety of complex data sets.

• Demonstrated capabilities in planning, participating, and managing a variety of complex analytics projects to meet required timelines.

• Solid experience using industry standard BI, statistical, or analytical tools and technologies.

• Epic Resolute Billing Expected Reimbursement Contracts Administration certification with a recommended three years experience.  Must maintain certification.

• Five years of experience in a role requiring management of projects and accountabilities from inception to conclusion in an effective and comprehensive manner that appropriately evaluates implications and results in solid solutions, securing beneficial results that add value and contribute to strategic direction.

• Five years of experience with revenue cycle, patient accounting, third party payer contracting and/or payer contract modeling system including knowledge of value-based contract payment structures and payment mechanisms.

• Demonstrated strong proficiency using word processing, spreadsheet, database, internet and e-mail, and scheduling applications.

• Demonstrated effective verbal and written communication skills which allow candidate to present advanced topics in a clear, concise, polished and professional manner.

• Demonstrated experience working efficiently and effectively with skilled professionals.

• Willingness to flex work schedule to meet required deadlines.

Preferred Qualifications

• Master's Degree in an analytics-related field such as statistics, mathematics, information systems, computer science, finance, economics, or an MBA with an emphasis in analytics. If degree is not in an analytics related field five years of analytics experience demonstrating proficiency performing the job essentials at this job level.  Degree must be obtained through an accredited institution. Education is verified.

• Demonstrated proficiency and an advanced working knowledge of SQL (structured query language).

• Interpersonal skills - interacts effectively with individuals both inside and outside of organization; relates openly and comfortably with diverse groups of people.

• Five years of Epic contract build, billing and revenue cycle experience.

• Knowledge of State and CMS program payment methodologies and regulations.

#LI-EXECRC

Physical Requirements

• Ongoing need for employee to see and read information, labels, monitors, documents and be able to assess customer needs.
• Frequent interactions with customers that require employee to communicate as well as understand spoken information, needs, and issues quickly and accurately.
• Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer, phone, and cable set-up and use.
• Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.
• Expected to lift and utilize full range of movement to transport, pull, and push equipment. Will also work on hands and knees and bend to set-up, troubleshoot, lift, and carry supplies and equipment. Typically includes items of varying weights, up to and including heavy items.

Location:

Key Bank Tower

Work City:

Salt Lake City

Work State:

Utah

Scheduled Weekly Hours:

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience. 

$56.49 - $88.91

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.