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Insurance Credentialing & Payer Contract Management Supervisor

JOB-ID: 4991

Job Title Category Location Job Type Posted
Insurance Credentialing & Payer Contract Management Supervisor Administrative/Clerical Miramar, FL 33025 Full-Time 09-01-2020
  • Responsible for day-to-day operational and functional activities of the Contract Services team.  Coordinates and maintains key internal relationships and provides leadership to all customers.  Negotiates successful resolutions to problems and concerns.  Educates customers about the contract process.
  • Responsible for supervising rates (charge master) within the industry and keeping up to date research to maintain corporate strategy, preparation, and execution for VITAS’ current and future healthcare services: hospice, managed care, physician, nursing home, respite, billing (RCM) & claims payments. Monitor the administration of the dissemination of rates information. Organize the training of corporate, program and department employees.

Core Supervisory responsibilities:

  • Supervise staff as first-level leadership implementing strategies, processes, and guidelines
  • Determine work procedures, prepare work schedules, and expedite workflow
  • Evaluate and standardize procedures to improve efficiency of subordinates
  • Observe and evaluate employees and work procedures to ensure quality standards and service is met
  • Provide feedback regarding personnel actions such as new hire requests and discharges, to ensure proper staffing
  • Attend meetings, training activities, courses and all other work-related activities as required
  • Perform related duties as required. This position description in no way states or implies that these are the only duties to be performed by the employee occupying this position.  Employees will be required to perform any other job-related duties assigned by their supervisor or management.

Additional Supervisory responsibilities Contract Management:

  • Assist in developing, creating, and maintaining contract templates in conjunction with legal departments review.
  • Take lead role in planning and coordinating any contract related projects. Leads team activity to accomplish project goals.
  • Take lead role in coordinating all survey and audits from any regulatory agencies or internal compliance departments. Leads team activity to accomplish survey/audit goals.
  • Provide contract training for any users within the company that accesses the contract system.
  • Assist as back up administrator to contract system and maintains expert knowledge of updating and maintaining contract system issues.
  • Review complex contract requests and prepares specialized and/or non-routine response for proposals and contract modifications.
  • Analyze significant, and/or unique contract requirements, special provisions, terms and conditions to ensure compliance with appropriate laws, regulations, and corporate policies and business unit procedures.
  • Provide authoritative guidance to internal business teams on corporate goals and objectives relating to contract activity. Focal point for all communication with legal, finance (Accounts Payable/Billing) and business team disciplines for resolution of contract issues and disputes.
  • Assist in identification, development and implementation of new contract policy and processes. Mentor and train less experienced professionals.
  • Process contract requests and assist in the drafting of contracts using standard parameters.
  • Ensure efficient and effective implementation of VITAS contracts.
  • Provide superior service to all internal/external customers.
  • Provide excellent customer service problem solving.
  • Support Claims and Accounts Payable manager
  • Maintain an acceptable level of production as established by management.
  • Assist other units within the department as requested by management.

Additional Supervisory responsibilities Charge Master / Rates:

  • Advise of changes within nursing home state rates, Medicare, and Medicaid physician rates as communicated by State entities for each program and CMS
  • Analyze, evaluate and disseminate to Accounts Payable payment rate information related to: ambulance, anesthesia, drugs, x-rays, DME, laboratory, and surgery fee schedules.
  • Monitor and coordinate between VITAS Information Technology, Revenue Cycle Management, and Accounts Payable to ensure rates system integrity and accuracy.
  • Ensure geographic tables for program billing and prepare reports to monitor and identify trends.
  • Encourage well-documented, trusted facts and sources upholding excellent research skills.
  • Identify improvement processes and recommendations to create and maintain organizational effectiveness within the department and act as a lead with Rate Specialists.
  • Resolve issues while keeping abreast of the changes in industry rates/trends to maintain corporate strategy within the business function.
  • Analyze state and legal requirements to ensure compliance with law, regulations, corporate, and business policies and procedures.
  • Forecast predictions that may affect rates to remain aligned with the strategic direction of the business.
  • Perform related duties as required. This position description in no way states or implies that these are the only duties to be performed by the employee occupying this position.  Employees will be required to perform any other job-related duties assigned by their supervisor or management.
QUALIFICATIONS
  • Five to seven years relevant experience in healthcare, accounting/billing, statistics, contracts or related fields.
  • Experience in a supervisory role successfully leading a team
  • Ability to effectively apply the policies and practices involved in the human resources function.
  • Working knowledge of corporate and department policies and procedures, coupled with ability to identify required improvement to established policies.
  • Ability to supervise staff in an engaging environment maintaining workforce production and development
  • Ability to work on various assignments simultaneously
  • Strong interpersonal skills within all levels of the organization
  • Strong to excellent analytical and communication skills.
  • Good presentation, leadership and team-building skills.
  • Working knowledge of computers, internet access, and the ability to navigate within an automated systems as well as a variety of software packages such as Outlook, Excel and Word.
  • Ability to draft moderate to complex, non-routine contractual instruments.
  • Proven working knowledge of Medicare/Medicaid reimbursement methods
  • Use of independent judgment and creativity applied to resolution of contract issues.
  • Ability to work independently with little supervision.
  • Ability to communicate tactfully, verbally and in writing with department heads, managers, coworkers and vendors to resolve problems and negotiate resolutions
  • Ability to lead, providing subject matter guidance to team members in a positive and productive manner by motivating and developing colleagues
  • Strong interpersonal skills within all levels of the organization
EDUCATION
  • Bachelor’s degree in accounting, business administration or related field from an accredited college or university or the international equivalent preferred.
SPECIAL INSTRUCTIONS TO CANDIDATES
  • EOE/AA M/F/D/V

Why VITAS Healthcare and What Do They Offer Me?

VITAS Healthcare is the nation’s leading provider of end of life care. We provide our employees opportunities for professional growth, advancement and competitive benefits.

Benefits Include:

- Competitive compensation 
- Health, dental, vision, life and disability insurance
- Pre-tax healthcare and dependent care flexible spending accounts
- Life insurance
- 401(k) plan with numerous investment options and generous company match
- Cancer and/or critical illness benefit
- Tuition Reimbursement
- Paid Time Off
- Employee Assistance Program
- Legal Insurance
- Roadside Assistance
- Affinity Program
Choose a Career with VITAS

We offer a variety of full-time, part-time and per-diem employment opportunities. You can choose to work day or night shifts, weekdays or weekends.

Employees earn competitive salaries and have the flexibility to choose a benefits package suitable to their own needs and lifestyle.