This person will be responsible for working with a sub-set of large Health Plans (United plus others to be determiend based upon capacity) to improve our performance of disputed claims collections and resolution. This person will establish and lead monthly / Qrtly JOCs with the Health Plans and ensure both Conifer and the Health Plan are following all aspects of the contractâ��s operational components regarding claims payment timeliness, appeals and IROs. This person will be expected to intervene when AR and/or problems arise in the claims resolution process. This person will draw upon their prior experience with Health Plan negotiations and Rev Cycle operations and claims resolution to ensure we implement best practices to maximize the realizable value under the contract. This person will develop relationships at the top of the Health Plans claims infrastructure as well as internally within Managed Care, Conifer and Tenet Operations. This person will also be able to perform specialized analytics on net revenues and aged AR data identifying trends for resolution
Bachelorâ��s degree in healthcare management, public health, accounting, finance, business, social or behavioral sciences with a Masterâ��s degree preferred
10 years combined experience in Managed Care contracting and Revenue Cycle
Ideal candidate will have both provider and Health Plan experience
Ideal candidate will have demonstrated capacity for results-oriented operational skills in managed care environment
Primary Location: Dallas, Texas
Facility: 984-Fort Lauderdale, FL
Other Locations: Alabama,California,Florida,Georgia,Louisiana,Massachusetts,Missouri,North Carolina,Nebraska,Pennsylvania,South Carolina,Tennessee,Texas,New Jersey,Washington,Colorado,Montana,Michigan,Washington D.C.,District of Columbia,New York,Idaho,Kansas,New Mexico,Kentucky,Iowa,North Dakota,Minnesota,Arkansas,Oregon,Maryland,Arizona,Virginia,Indiana,Illinois,Ohio,Wisconsin,Hawaii,Rhode Island,Connecticut
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 2105012932
Tenet Healthcare Corporation (NYSE: THC) is a diversified healthcare services company headquartered in Dallas with 112,000 employees. Through an expansive care network that includes United Surgical Partners International, we operate 65 hospitals and approximately 510 other healthcare facilities, including surgical hospitals, ambulatory surgery centers, urgent care and imaging centers and other care sites and clinics. We also operate Conifer Health Solutions, which provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other clients. Across the Tenet enterprise, we are united by our mission to deliver quality, compassionate care in the communities we serve.