Summary of Position: 
Accountable for the oversight and management of one or more specific Payment Integrity vendor contracts. Lead day to day operations for all activities related to one or more specific vendor contracts, contract optimization, implementation of new programs and business ownership of all EPMO and IT projects associated with vendor contract(s).

Responsibilities:

Responsible for specific contracts in Enterprise Payment Integrity. Serve as a primary subject matter expert for each contract to ensure optimal contract management and outcomes. Act as a point of communication and coordination with all internal business units for all issues related to vendor contracts. Responsible for “end to end” contract management which includes performing all pre-contractual and implementation activities, business ownership of EPMO and IT projects, development of contract performance standards and associated penalties, root cause analysis and ongoing monitoring and oversight. Actively participate in all related Policy Meetings, Quarterly Business Reviews, Reimbursement Policy Committees, Steering Committees. Create monthly savings reports and identify and address trends in comparison to established goals. Complete monthly invoices and reconcile against Oracle system reporting. Identify system enhancements and process improvements which will result in enhanced reporting and savings. Apply project management skills to complete related projects and assignments. Identify and recommend new programs, savings opportunities, and ways to optimize current contracts. Engage vendors and internal business units to review opportunities and lead business case development, savings opportunity analysis, and creation of EPMO or IT related projects.

Qualifications:

Bachelor’s degree AAPC CPC (AAPC Certified Professional Coder) &/or CCS (AHIMA Certified Coding Specialist) Master’s Degree preferred 3 - 5+ years or relevant, professional experience in health care contracting and management required Additional experience/specialized training/certifications may be considered in lieu of bachelor’s degree requirements required Strong understanding of the healthcare industry, managed care and health plan operations required Experience in managing large, complex contracts required Experience with performance improvement required Excellent organizational, prioritizing, and project management skills; ability to manage multiple/complex projects required Proficiency in MS Office (Word, Excel, PowerPoint, Access, Outlook) required Knowledge of claims operating platforms required Effective communication skills (verbal/written/presentation/interpersonal) with all types/levels of audience required Additional Information Job Type: Standard Schedule: Full-time Employee Status: Regular Requisition ID: 24058 Hiring Range: $51,900 - $80,000