Physician

Job Details

Bayhealth Medical Center is Central
and Southern Delaware’s healthcare leader with hospitals in Dover Kent Campus
and Milford Sussex Campus a stand-alone ED in Smyrna and a hybrid ED/Urgent
Care in Milton Bayhealth TotalCare. Bayhealth Medical Center provides a wide
range of healthcare services including cardiac surgery neurosurgery
orthopedics and rehabilitation pediatrics level II neonatal ICU radiology
and women’s services. We are COMMITED to provide excellent compassionate care
to our many patients providing them with a comforting experience in their time
of need and crisis. Bayhealth Medical Center is affiliated with the Penn
Cancer Network and the University of Pennsylvania-Penn Orthopedics New Graduate
Medical Education programs for physicians – teaching institutions are centers
that value growth education and collaboration.
Forbes 2024 List of Best Place to work by State! Bayhealth Medical Center ranked #3 in
Delaware.
Our healthcare system has more than 4500 employees.
Bayhealth Medical Center Kent Campus is 90 minutes from
Philadelphia Washington DC and Baltimore.
Our Sussex Campus is 30 minutes to the Delaware beaches and relaxation
in the sand!
Bayhealth Medical Center offers competitive salary and a
comprehensive benefits package including:
Paid Time
Off and Paid Holidays
Matching
401k/403b Plans
Excellent
Health Dental Vision Disability and Life Insurance options
Bayhealth Medical Center is looking for a Contracting amp Payer Relations
Executive Director who is engaged in their profession committed to providing
the best service and believe in the mission of Bayhealth. We are looking for
staff with Compassion Accountability Respect Integrity Teamwork.
Whether
you are seeking work/life balance or the excitement of never knowing what is
coming in the door next we can help connect you to your future!
Location:
Kent Campus Hospital
Status: Full
Time 80 Hours
Shift:
Days
SALARY
STARTING: 140940.80 YEARLY

General Summary:
Reporting
to the CFO the Executive Director of Contracting amp Payer Relations is
responsible for all aspects of managed care governmental value-based and
population health/clinical integration for Bayhealth Medical Center and
Bayhealth Medical Group. The position is charged with developing and improving
relationships with third-party payers. As a key member of the Revenue Cycle
team the senior director ensures reimbursement rates are as robust as possible
and that third-party payers are abiding by the contract terms. The
Executive Director works collaboratively with the other Revenue Cycle leaders
and key stakeholders to make certain that everyone is aware of and strives to
correct issues or disagreements arising with payers.
Responsibilities:
1.
Negotiates agreements with third-party payers to achieve operating terms and
reimbursement rates that will support Bayhealth’s strategic goals.

2. Generates reports that describe the successes and opportunities in the
revenue cycle.

3. Meets with leadership of Delaware based plans to discuss strategic plans and
opportunities for improvement and collaboration.

4. Recommends managed care contracting strategy to CFO.

5. Serves as the primary source of communication and liaison with third-party
payers.

6. Fosters effective collaboration between departments to ensure a consistent
and integrated approach in daily operations to managed care requirements.

7. Collaborates with Denials Department to create effective appeals.

8. Conducts regularly scheduled meetings with third-party payers to improve
payment processes and follow-up on claims due and other outstanding issues.

9. Represents Bayhealth in state-wide meetings and participates with regional
associations.

10. Accountable for the overall success of Bayhealth’s managed care strategy.

11. Maintains the EPIC contract management system.

12. Ensures that annual payment adjustments are accurate and complete.

13. Creates Price Transparency machine-readable files each year.

14. Serves on utilization review level of care and readmission committees.

15. Negotiates single-case agreements as required.

16. Provides input on charge master development and adjustments.

17. All other duties as assigned within the scope and range of job
responsibilities.

Required Education Credentials and Experience:
Education:
Master Degree Business Administration
Credentials:
None Required
Experience:
Required: Minimum 10 years of contract negotiation with Managed Care
Organizations

Preferred Education Credentials and Experience:

Education:
Master Degree Health Administration or Related field
Credentials:
Certification related to the position if applicable.
Experience: