Manager - Payer Strategies - Acute

University Health Services Inc

LAS VEGAS, NV

JOB DETAILS
SKILLS
Analysis Skills, Bid Analysis, Billing, Budgeting, Business Support, Case Management, Communication Skills, Computer Operations, Continuous Improvement, Contract Analysis, Contract Creation, Contract Management, Contract Negotiation, Contract Requirements, Contract Review, Database Administration, Database Programming, Editing, Finance, Financial Analysis, Financial Trend Analysis, Health Economics, Health Insurance, Healthcare, Healthcare Administration, Healthcare Providers, Healthcare Reimbursement, Hospital, Hospital Administration, Identify Issues, Language Interpreter, Leadership, Maintain Compliance, Managed Care, Market Share, Market Tracking, Medical Organizations, Multitasking, Negotiation Skills, Performance Analysis, Performance Metrics, Performance Modeling, Performance Reviews, Prescription Drugs, Presentation/Verbal Skills, Problem Solving Skills, Provider Relations, Record Keeping, Regulations, Regulatory Compliance, Reimbursement, Spreadsheets, Strategic Planning, Time Management, Trend Analysis, Utilization Management, Willing to Travel, Word Processing, Writing Skills
LOCATION
LAS VEGAS, NV
POSTED
30+ days ago

Responsibilities

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 300 corporation, annual revenues were $15.8 billion in 2024. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies.

Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.

Manager - Payer Strategies (Acute) (Nevada Market)

This role is focused on the tactical execution, administration and maintenance of hospital and physician managed care contracts and offers guidance on rate proposals and negotiation approaches. This position manages the full contract negotiation cycle for assigned contracts, focusing on specific financial reimbursement terms, rates, and language.

Key Responsibilities:

• Coordinates the implementation of new or renegotiated contracts within the organization and ensures compliance with contract terms and collaborates with the internal stakeholders to monitor payment accuracy and contract performance. • Serves as subject matter expert on contract specifics for the revenue cycle team and case management teams. • Provides support for negotiations and to monitor contract performance metrics. • Develops strategies for contract relationships and negotiations. • Responds to market opportunities and monitors significant market changes to protect and enhance market share for the UHS-NV Region. • Analyzes the significance and value of potential contracts. • Determines the cost of care based on care delivery and contract structure. • Projects contract performance based on modeling of actual and representative samples. • Develops contract language to protect UHS-NV Region's best interest and satisfy strategic contracting objectives.

Contract Management Responsibilities:

• Develops structures that are appropriate to the institution. • Includes full range of reimbursement structures whether hospital, physician, ASC, bundled payments, capitation, etc. • Considers cost of care or performance targets in relation to the size and scope of the contract. • Develops and analyzes rates for proposals or counter proposals. • Serves as a liaison and knowledge resource to Revenue Cycle and other Operational Departments regarding ongoing contract compliance to support key business functions and contribute to continual improvement.

Contract Analysis and Negotiation Responsibilities:

• Analyzes and monitors contract requirements, special provisions, terms, and conditions to ensure compliance with appropriate laws, regulations and UHS-NV Regional policies and business procedures. • Determines how the Contracting Department can assist with processes, communication, and interpretation of language for Revenue Cycle and other Operational Departments. • Engages in preparation and planning of annual renegotiations. • Reviews and develops contract language, maintains historical records of payor/contract information. • Participates in negotiation strategy. • Offers suggestions to Regional and Corporate leadership for changing future contracts based on review of existing contracts.

Operational Responsibilities:

• Establishes and implements a consistent schedule of Joint Operations Committee (JOC) meetings with key payors. • Addresses contract performance, including, but not limited to, revenue cycle, utilization management, as well as other operational issues. • Works with key internal and external stakeholders to establish JOC Meeting agenda and leads them as required. • Provides ongoing analysis and reporting on existing contracts for compliance, performance reviews, net revenue budgeting, long-range planning, and survey responses. • Studies historical utilization and trends in revenues through financial data. • Identifies issues with the operation of contracts. • Updates the Regional Director of Managed Care and Payer Strategies on unexpected changes in the planned performance of contracts.

Qualifications

• Bachelor's degree in finance, Business/Economics, Healthcare Administration, or a related field. Master's Degree preferred. • A minimum of five years of experience in a healthcare organization, or within the health insurance industry, working with provider network development, provider relations, billing cycle and contract negotiations is required. • Experience in a large healthcare organization or academic medical center is preferred. • Proven track record in contract negotiations.

Skills

• Advanced computer operation competency with the ability to utilize spreadsheet, word processing, calendar, and email applications effectively. • Practiced in managed care database development, management, and navigation. • Negotiation expertise along with acumen to achieve stretch goals in difficult circumstances. • Disciplined in handling challenging communication professionally. • Ability to work across organizations and represent physicians and hospital interests. • Excellent organization, time management and problem-solving skills with the capacity to meet deadlines while managing multiple tasks. • Adept at tracking, editing, and monitoring complex contracts with multiple language changes and addenda. • Detailed in the attention to language and rate structures in contracts. • Effective written and verbal communication skills.

Travel: Up to 5% US or internationally travel

This opportunity offers the following:

• Challenging and rewarding work environment • Growth and Development Opportunities within UHS and its Subsidiaries • Competitive Compensation • Excellent Medical, Dental, Vision and Prescription Drug Plan • 401k plan with company match • Generous Paid Time Off

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

Notice

At UHS and all subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates with matching skillset and experience with the best possible career at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail etc. If you feel suspicious of a job posting or job-related email, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449

About the Company

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University Health Services Inc