Days, Full-time

Location: Remote/work from home with strong preference for candidates residing within the UPH geographies of Iowa, Illinois, & Wisconsin. Onsite arrangements can be made for Des Moines, IA if the candidate prefers to work in office.

Supports Contract Managers and Director in managing third-party payor contracts. Works directly with Senior Leaders to facilitate contract negotiations. Responsible for managing and tracking provider/payor contractual and payment issues. Negotiates minor amendments and manages complex, escalated issues from internal stakeholders.

At UnityPoint Health, you matter. We’re proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row for our commitment to our team members.  

Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in.  Here are just a few:      

• Expect paid time off, parental leave, 401K matching and an employee recognition program.   

• Dental and health insurance, paid holidays, short and long-term disability and more. We even offer pet insurance for your four-legged family members.  

• Early access to earned wages with Daily Pay, tuition reimbursement to help further your career and adoption assistance to help you grow your family.   

With a collective goal to champion a culture of belonging where everyone feels valued and respected, we honor the ways people are unique and embrace what brings us together.   

And, we believe equipping you with support and development opportunities is a vital part of delivering an exceptional employment experience. 

Find a fulfilling career and make a difference with UnityPoint Health.

Contract Implementation

• Evaluates and negotiates third-party payor contractual amendments for UnityPoint Health providers, which affect business operations substantially and have a significant impact on reimbursement for UPH.
• Coordinates and assists with the administration of assigned contracts.
• Acts as a subject matter expert, advising senior leaders when to facilitate negotiation of third-party payor contracts and associated amendments for UnityPoint Health providers, as assigned.
• Collaborates with Law Department and Revenue Cycle to ensure contracts meet system requirements.
• Understands the financial impact of contract reimbursement.
• Manages escalation of contract implementation and claim administration issues from Revenue Cycle and Business Units. Collaborates with assigned payors and SMEs to track issues through resolution. Communicates outcomes to internal and external stakeholders, as necessary.
• Manages escalated claim related settlement processes, collaborating directly with internal revenue cycle, finance experts and Payors. Manages compilation of claims data and storage/tracking of settlements from start to finish.
• Monitors contract completion, extension and renewal. Communicates/collaborates with Contract Implementation Specialist to translate updates, changes to SharePoint.
• Ensures contractual language is interpreted correctly by internal stakeholders and collaborates to with Payors to communicate UPH interpretation of language.
• Coordinates with Contract Manager on complex negotiations and drafts contract documents.
• Develops, manages, tracks, trends and reports on escalation of issues from Revenue Cycle and Business Units and communicates resolution to internal stakeholders.
• Develops and implements training for internal stakeholders on Payor relationships, contract terms and department workflows.
• Researches and recommends solutions for issues related to contract administration.
• Facilitates audits on assigned contracts.
• Facilitates regular meetings with assigned Payors to track progress on various contracting initiatives.
• Develops ad hoc reports as requested or assigned.
• Assists with special projects, as requested by Contract Managers and Director.

Education: 

• High School Diploma/GED
• Preferred: Bachelor's degree in accounting or healthcare related field

Experience:

• Two (2) years of healthcare management or equivalent related experience.
• Previous experience with third-party payors

Knowledge/Skills/Abilities:

• Excellent written and verbal communication skills
• Work as a team member, creating and maintaining effective working relationships with internal and external customers.
• Ability to understand and apply guidelines, policies and procedures
• Ability to effectively utilize Microsoft Office programs to complete work (Word, Excel)

What are team member vaccine requirements?   

As part of keeping our communities safe and healthy, all team members must be vaccinated for influenza and Tdap, provide proof of immunity to MMR and varicella, and be tested for tuberculosis.  New hires must submit proof of vaccination or an approved exemption to begin work. If you have questions, please contact a recruiter or ask at any time during the interview process. UPH strongly recommends that all team members receive the updated COVID-19 vaccine, and at this time, UnityPoint Health – Meriter requires Covid-19 vaccination or an approved exemption.