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FMOL Health · 1 day ago

Manager of Payor Relations

Baton Rouge, LA

Full-time

Onsite

Mid, Senior Level

5+ years exp

FMOL Health is focused on optimizing financial pricing and analysis of insurance contracts. The Manager of Payor Relations will collaborate with various departments to ensure accurate payment data and enhance reimbursement strategies.

Health Care

Responsibilities

Develops and maintains financial information related to volume, financial performance and profitability for each managed care contract for all FMOLHS affiliated entities

Extracts and analyzes historical data to help direct reimbursement strategies

Responsible for updating and maintaining the Contract Management module of the cost accounting system to ensure accurate financial reporting and analysis of payor data

Works with all FMOLHS affiliated entities and their information systems to identify revenue enhancement opportunities and to quantify the financial impact of changes to contract reimbursements

Facilitates the operational process of managed care contracts by working with internal and external stakeholders to ensure policies and procedures are followed by hospital personnel in a manner that facilitates high quality patient care and accurate reporting

Assists Corporate Director of Payor Relations with contract negotiations for FMOLHS hospital and affiliated entities

Possesses the ability to resolve day-to-day managed care operational issues with contracted payers and serves as a liaison to FMOLHS hospitals and medical staff to provide continuous communication in regards to managed care contracts, plans and products

Responsible for benchmarking payment rates and cost to other hospitals, surgery centers, clinics or health systems

Analyzes and prepares clinical and financial data in requested operational service lines

Serves as the financial analyst in the supporting of partnerships and joint venture arrangements

Strives to promote the quality and efficiency of his/her own performance by remaining current with the latest trends in field of expertise through participation in job-relevant seminars and workshops, attendance at professional conferences, and affiliations with national and state professional organizations

Qualification

Financial AnalysisReimbursement MethodologyContract ManagementEPIC CertificationsManaged Care ExperienceMath SkillsLogic Skills

Required

5 years Hospital, Physician Office or Managed Care Experience

Bachelor's Degree

Strong Math and Logic Skills

Reimbursement methodology skills a plus

Preferred

EPIC Certifications must be obtained within 12 months of employment

Resolute Professional Billing Reimbursement Contracts and Resolute Hospital Billing Expected Reimbursement Contracts Administration

Company

FMOL Health

FMOL Health is a bold, connected health system that delivers care that prioritizes people – every patient, every community, every time – while honoring the unique character of each market we serve.

Founded in 1984

Baton Rouge, Louisiana, USA

10001+ employees