Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Summary:

• Develop and retain an in-depth understanding of the managed care marketplace and the current operational challenges facing UPHS due to policy and procedure changes within the Plans. The primary responsibilities are to support the on-line and other electronic tools to provide all health system entities continual access to information relating to the current managed care agreements and creating and refining systems to ensure that all policy procedure changes by the managed care plans are communicated with an assessment of the impact to the system that may warrant a renegotiation of the contractual terms.

Responsibilities:

• Make and accept requests of/from other departments/entities in a way that clearly and reasonably specifies scope, deliverables, and required timing/deadlines.

• Serve as a Liaison to the Payors to aid in navigating through the health system for problem resolution.

• Serve as a resource to UPHS to ensure all questions are appropriately answered.

• Identify and remove revenue cycle barriers.

• Generate Reports to quantify the financial impact of operational/financial issues and performance improvement initiatives.

• Provide contract interpretation support for UPHS, Entity and Payors. Coordinate contract dispute and problem resolution as needed.

• Continually Improve educational programs/tools for UPHS and Entity staff.

• Provide contract interpretation support for UPHS, Entity and Payors. Coordinate contract dispute and problem resolution as needed.

• Maintain a means to communicate essential rate and operational information to UPHS and Entity stakeholders.

• Projects performed as required.

• Performs duties in accordance with Penn Medicine and entity values, policies, and procedures.

• Other duties as assigned to support the unit, department, entity, and health system organization.

Education or Equivalent Experience:

• H.S. Diploma/GED (Required)

• 2+ years of experience in an academic medical center, integrated delivery system, or large managed care company. (Required)

• 0-1 years of experience working in a managed care customer support/customer service role. (Required)

Skills/Abilities:

• Familiarity with managed care, healthcare operations, and reimbursement concepts.

• Must have good judgment, communication and interpersonal skills.

• Must be flexible to deal with ambiguous situations and changing environment.

• Must be able to deal tactfully with users and providers of health services.

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

REQNUMBER: 214277