AdventHealth Rocky Mountain Looking for Director Contract Administration at Englewood, Colorado Full Time

• Benefits from Day One
• Paid Days Off from Day One
• Student Loan Repayment Program
• Career Development
• Whole Person Wellbeing Resources
• Mental Health Resources and Support

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule: Full Time

Shift : Day

Location: 6901 S Havana St. Centennial, CO 80112

The role you’ll contribute:

This position is responsible for providing guidance and direction to the AHS Florida Division Contract Management team and AHS Multistate Contract Administration teams. This direction includes management of our reporting database, our electronic document storage system and the Contract Management systems for hospital and physician claims adjudication. Hospital administration includes all contracted, non-contracted, government, worker’s compensation and local provider contracts for hospital and ancillary contracts for Southeast, Southwest, Midwest, MidAmerica and Florida. Physician contract management includes managed care contracted payers. The Director of Contract Administration provides a complete contract review, interpretation and direction regarding all new and amended contracts to the Multistate Directors and supports the AHS Florida Division Contract Management team. This position facilitates communication between AHS Florida division, Multistate Division Directors, Patient Financial Services (PFS), Care Management and HIM coding to bring consistency in operations and enforcement of solution to contract/payer related issues.

The value you’ll bring to the team:

• Responsible for the direction of the electronic data storage system which inventories all Managed Care contracts for Florida, Multistate, Ancillary, Physician and Administrative contracts.
• Develop and incorporate best practices and issue resolution process through enhancing systems and procedures to support business needs.
• Responsible for the security rights of staff accessing the contract management systems.
• Maintains a working knowledge of hospital and physician contract management systems in order to direct and support the needs of the Contract Management and Contract Administration teams.
• Provides lead support and guidance to internal and external customers as it relates to changes or enhancement needs to functions of the contract management systems.
• Effectively communicates business expectations, operational changes and strategic positions to AHS leadership and Managed Care staff.
• Collaborates with Corporate AHS PFS Directors and Vice President of Revenue Management in determining best practices in order to meet the needs of Contract Administration and downstream customers such as PFS, Care Management and HIM.
• Creates and maintains a work environment that is aligned with the organization’s goals and strategies, demonstrating a unified voice and consistent message from leadership; actively supports all organizational policies and procedures in communications and interactions with staff.
• Communicates and implements change in a positive and effective manner.
• Coordinates and guides bimonthly meetings with the Multistate Managed Care Directors to discuss status and direction of payer negotiations, finance, operations and contract administration.
• Consults and works collaboratively with the AHS staff to ensure contract compliance and successful implementation of any commercial, Medicaid and Medicare managed care agreements.
• Supports AHS hospital facilities and PFS Departments to facilitate the A/R goals set by PFS leadership.
• Supports the AHS Denial Management leadership and team by monitoring the error reports to make sure they are worked timely and kept to a minimum.
• Provides review and response to AHS Managed Care Directors for contracts submitted for VP signature.
• Oversee decisions on administrative and operational matters, and ensure that operations execute on established objectives consistent with departmental strategies.
• Evaluate processes and identify opportunities to improve procedures and associated results by implementing functions that ensure operational excellence and financial success.
• Ensures business processes are in place that point to opportunities to improve business results and/or internal/external department satisfaction.
• Administer and advises to ensure the flow of contract negotiations is uninterrupted; tracking from receipt, signature by Sr. VP to mailing and notification to appropriate Director of contract status.
• Leads biweekly conference calls with Multistate Managed Care Directors to include Operations, Finance, Contract Administration and PFS for review and discussion of payor contracting status, contract language interpretation, contract administration system status and PFS payor issues that need escalation.
• Meets regularly with Contract Management and Administration staff to ensure contracts are loaded in a timely manner.
• Provides reporting to Multistate Managed Care Directors to verify payor renewals and auto increases are not missed protecting the hospital/regions revenue.
• Strategizes, analyses and develops initiatives requiring improvement for the Contract Administration team.
• Provides regular feedback to promote professional growth and learning and completes performance appraisals as required by AHS policy.
• Ensure execution of strategic and operational priorities; ensure an environment for quick problem solving customer service and decision making.
• Champion new initiatives and act as a catalyst for change.

Qualifications
The expertise and experiences you’ll need to succeed :

Minimum qualifications :

• High school Diploma or equivalent
• Minimum of five years’ experience in managed care or patient financial services
• Minimum of five years’ experience in the healthcare industry
• Mature, responsible and strong management experience
• Spreadsheet experience
• Email and computer calendar experience
• Highly analytical and able to understand business objectives
• Independent thinker and strong decision-making skills
• Strong prioritization and organization skills
• Effectively able to communicate with various levels of the organization
• Relationship building and developing foundation of trust

Preferred qualifications:

• Bachelor’s Degree in Business Administration, Healthcare Administration or related field
• Ten years’ experience in healthcare or insurance
• Microsoft Word, Excel, Power Point, Access, Outlook

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.