Program Manager of Payer Contracting |
| Location: | Salt Lake City, UT |
| Type: | Full Time |
| Department: | Marketing |
| Duties: | Responsibilities include:
• Manage all aspects of the insurance contracting process, including contract review, proposed edits, pricing, approvals and implementation.
• Develop programs to enhance contracting process to reduce turnaround time for review and approval.
• Develop programs to make payer contracts meet strategic clinical business goals related to pre-authorizations, policy exclusions, clinical selection criteria and price and new product amendments.
• Develop and implement programs to increase payer demand for contracts and provide qualified leads for the managed care team
• Develop and Implement New Product launch initiatives and materials targeting Managed Care Executives and payors
• Work with Managed Care Team to develop programs to support their field efforts and improve their efficiency
• Work with Customer Services and Billing team to identify areas of opportunity for further improvement in contracting, collections, DSO and reduce bad debt.
• Participate in the Lost Revenue Team to initiate and implement projects to reduce patient cancellations and improve capture rate.
• Work with Medical Services team to develop and maintain reasonable and appropriate patient selection criteria for both internal and payer use in determining medical necessity of services.
• Work with Legal team to develop standard language to address common barriers in contracting.
• Develop sales aids for the MCEs to communicate key issues during negotiations.
• Work with Marketing, Sales and Managed Care teams to initiate programs to persuade employers, employee organizations (unions) and insurance brokers to include and promote Myriad services in their health insurance coverage.
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| Qualifications: | BA/BS required, MBA strongly preferred.
5 years in product/marketing management in an area that includes contracting with payors and/or government
Critical Skills and Experience:
• Organizational Skills
• Demonstrated Project Management
• Understanding of the Healthcare Provider and Payor Marketplace
• Experience in Bids and Contracts
• Excellent Written and Verbal Communicator
• Quantitative and Business Analysis skills
• Strong Attention to Detail
• Creative Problem Solver
• Negotiation Skills
• Multitasking
• Meeting Deadlines
• Strong Desire and Ability to improve productivity in oneself and others
• Diplomatic
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