All the benefits and perks you need for you and your family:
Benefits from Day One
Whole Person Wellbeing Resources
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
The role you’ll contribute:
Manages a strong working relationship with AdventHealth Florida Division leadership, AdventHealth Central Denials, Regional Revenue Cycle leadership including CFO, VP, CM, UR, CBO, Patient Access, Revenue Integrity, HIM and ancillary providers. Promotes awareness and guides operational standards to ensure compliance of negotiated contract terms, rates and policies including; governmental initiatives, rules and regulations. This position is responsible for the mentorship of the Contract Manager. The Sr. Contract Manager will provide oversight and guidance to the Contract Manager and their duties as they relate to payer contract rates, systems and relationships. The Sr. Contract Manager takes on more of an analytical role working to strategically problem solve and prepare issues for escalation to executive leadership and the Corporate Compliance Committee. Collaborates with Sr. Negotiators to prepare disputes with payers regarding policy changes that negatively impact contract operations and net revenue to the organization.
The value you’ll bring to the team:
Demonstrates ability to build, maintain and test in complex contract management systems with a high degree of accuracy.
Strong ability to mentor and train complex systems to pertinent staff.
Responsible for ensuring system builds are audited to acceptable standards.
Responsible for netting down system-wide accounts receivable.
Responds to frequent inquiries from the corporate Net Revenue Accounting department to facilitate with month end net revenue calculations.
Responsible for ensuring accurate patient estimation by providing direction to external vendor or through internal reimbursement calculations.
Responsible for summarizing key contract data elements which are populated into the Managed Care database including addition of new payers, auto increases, renewals and termination.
Accountable for accurately reporting key contract data elements to AdventHealth Florida Division leadership and ancillary facilities.
Responsible for ensuring that the contract image database is maintained with current information that accurately represents contract activities. This includes providing all correspondence and contract language, including rate updates, to the Information Systems Coordinator for scanning with appropriate filing form for the purpose of reporting accurate information to hospital and ancillary department leadership.
Provides the necessary feedback regarding system failures or inefficiencies so that the operational function of contracts and labor performance is not compromised.
Facilitates Regional PFS departments, Case Management, Denial Management and ancillary facilities in articulating operational contract issues to the Payers and provides the forum to effectively discuss and share information between AdventHealth and payers.
Maintains communication and coordinates with Payer to ensure timely execution of contract rate implementation.
Ensures hospital staff, leadership and ancillaries are aware of any payer policy updates, operational changes, and governmental initiatives that may have a direct or indirect impact on hospital operations or contract terms and rates. Guides and directs facilities on processes based on this communication.
Represents self and this organization in a professional and courteous manner and aligns self with the mission of AdventHealth so that every interaction is a true representation of our organization’s goals and values.
Responsible for protecting confidential patient and contract information. Respects the privacy of patient related matters and ensures expeditious handling of related issues.
Supports the growth and development of the Contract Manager in the capacity of both system and strategy.
Supports and serves as liaison between Florida Regional PFS departments, payers, co-workers, Case Management, ancillaries, various hospital departments and leadership relative to continued education and the resolve of operational issues.
Chairs quarterly Joint Operation Committee meetings consisting of key revenue cycle stakeholders, including but not limited to, medical directors, utilization management leaders and equivalent representatives from the health plan.
The expertise and experiences you’ll need to succeed:
Bachelor’s degree or 5+ years of experience
High degree of competency in contract language interpretation
Ability to problem solve and think analytically
Effectively communicate with all department levels
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.