Military Spouse Connection Jobs

Description

We are seeking a strategic and dynamic

professional to develop, negotiate, and manage our partnerships with

Independent Practice Associations (IPAs), physician groups, hospitals, and

ancillary and supplemental providers.

Key

Responsibilities include:

• Cultivating and negotiating value-based agreements with IPAs, physician groups, hospitals, and other healthcare providers.

• Establishing and maintaining robust networks, ensuring strong relationship management and support post-establishment.

• Ensuring all agreements align with organizational goals and comply with regulatory requirements.

• Drive the creation of value-added partnerships that benefit all stakeholders involved.

• Utilizing your deep understanding of comprehensive reimbursement methodologies to enhance network efficiency and effectiveness.

• Managing and training a team of regional contract managers

Salary Range: $105,200-$250,600/annually

Qualifications

We're seeking a strong leader with:

• A Bachelor's degree in Business Administration, Health Care or related field or equivalent experience/training

• 10 or more years of experience in Medicare or Managed Care Contracting with experience in complex contract negotiations

• 5 or more years of managing regional contracting teams

• Proficiency in contract and benefit interpretation

• Deep understanding of Managed Care systems (e.g. EZ Cap, QNXT, Facets, EPIC/Tapestry) and operational impacts

• Knowledgeable in physician and facility billing, CPT, ICD-10, Revenue, and HCPCS coding

• Strong working knowledge of regulatory standards (HIPAA, DMHC, AB1455, CMS) and provider network/IPA Arrangements, reimbursement methodologies, and health benefit plan concepts

• Proficiency in Microsoft Office Suite and data visualization tools

• Excellent oral and written communication skills, strong interpersonal skills, and ability to work well in team settings.

UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.