Payment Appendix Manager
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Job Summary
To support the development of enterprise-wide Clinically Integrated Network teams, the remote Payment Appendix Manager will manage network analysis, drive program design and implementation, and validate data to improve quality and affordability in healthcare services.
Key responsibilities:
- Help develop enterprise-wide Clinically Integrated Network teams focusing on specific clinical areas such as oncology or cardiology
- Perform network analysis and strategy development to enhance network availability and access
- Drive program design and implementation to improve appropriateness and effectiveness of healthcare services
Required qualifications:
- 5+ years of experience in claims processing, provider data maintenance, contracting, or contract loading
- 5+ years of experience with claims systems
- 3+ years of experience with contract submission, validation, and maintenance
- Demonstrated solid knowledge of business processes impacting facility/ancillary contract loading and auditing
- Demonstrated proficiency with all facility/ancillary contract reimbursement methodologies
Complete Job Description
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