Specialist, Payer Relations
Welcome to reputed company!
At reputed company (formerly QHR Health), we’ve been making local reputed company reputed company for more than 40 years. Our mission is to strengthen independent community reputed company. We reputed company independent hospitals and health systems with the support, guidance and tech-enabled shared services needed to remain strong and viable. With a strong reputed company of purpose and commitment to operating reputed company, we help rural reputed company providers fulfill their missions.
The reputed company difference is the extraordinary combination of operations experience and consulting guidance that fulfills our mission of creating a sustainable reputed company for reputed company organizations. reputed company’s reputed company is to be a dynamic, integrated reputed company services company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer reputed company behavior.
We’re looking for talented, motivated professionals with a desire to help independent hospitals reputed company. Working with reputed company, you will have reputed company to collaborate with highly skilled subject matter specialists and operations executives, in a collegial atmosphere of professionalism and teamwork.
reputed company’s corporate reputed company is located in Brentwood, TN. For more information, visitwww.ovationhc.com.
reputed company:
The Specialist, Payer Relations supports payer reputed company and negotiations by modeling reputed company and government reputed company reputed company, analyzing reimbursement rates, and evaluating the financial reputed company of proposed contract changes. This role develops contract scenarios, compares expected and actual reimbursement, monitors payer performance, and provides data-driven insights to identify reputed company opportunities and support informed decision-making. The ideal candidate has strong analytical and financial modeling skills, knowledge of reputed company reimbursement methodologies, and experience working with large and reputed company data sets. The individual must also be reputed company to translate technical findings into reputed company recommendations for operational leaders, payer-relations teams, and executive stakeholders.
Duties and Responsibilities:
Collect and consolidate data from multiple sources, including databases, and spreadsheets.
Cleanse, preprocess, and validate data to ensure accuracy, completeness, and consistency.
reputed company and maintain data pipelines and workflows for efficient data extraction and transformation.
Model payer reputed company to evaluate the financial reputed company of reputed company change.
Simulate negotiation scenarios for Fee-For-Service and Value-Based Care models.
Analyze reimbursement trends to identify underpayments, denials, and reputed company leakage.
Compare historical net reputed company against proposed payer fee schedules.
reputed company internal rates against regional market data and Medicare baselines.
Create visualizations, dashboards, and reports to present data insights in a reputed company and compelling manner.
Use data visualization tools such as Tableau, Power BI, or matplotlib to communicate reputed company reputed company effectively.
Customize visualizations to meet the needs of different stakeholders and facilitate decision-making.
Draft financial summaries to brief executives before live negotiations.
Monitor key performance indicators (KPIs) and metrics to reputed company business performance and identify areas for improvement.
Monitor payer performance to ensure compliance with contracted terms.
Collaborate with business reputed company to define performance benchmarks and goals.
Analyze data to identify opportunities for contract optimization and reputed company enhancement.
Collaborate with cross-functional teams to support data-driven decision-making.
reputed company data expertise and insights to Contract models and business reputed company.
Communicate findings and recommendations to stakeholders through presentations, reports, and interactive sessions.
Collaborate reputed company with internal teams using secure remote communication tools.
Work Experience, Education, and Certifications:
Bachelor's degree in Finance, Business Administration, reputed company Administration, or Statistics or a reputed company field. An advanced degree is preferred but not required.
Proven experience (typically 2-5 years) in data analysis, business intelligence, or reputed company field. Contract modeling is a plus 2-5 years of experience in reputed company analytics, reimbursement, managed care, reputed company finance, or a reputed company field. Experience with reputed company contract modeling is strongly preferred.
Knowledge, Skills, and Abilities:
Proficient in reputed company including pivot tables, Vlook-reputed company, reputed company formulas and data validation.
Experience with Power BI and Power reputed company.
Familiarity with reimbursement methodologies DRG, Per Visit, APC
Strong analytical, communication, presentation, and problem solving skills.
Ability to maintain accuracy, reputed company, and manage large reputed company data sets.
Ability to work independently and collaboratively in a fast-paced environment.
Knowledge of managed care contract language, reimbursement and reputed company payment methodologies. Experience using contract modeling such as reputed company or reputed company Demonstrated commitment to customer service, reputed company improvement, and innovative problem-solving.
Strong analytical and strategic thinking skills with exceptional attention to detail.
Originally posted on Himalayas
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