Job Details

This role is responsible for leading payer contracting strategies and managing key relationships with health plans to optimize reimbursement, strengthen financial performance, and support the Enterprise's mission of delivering high-quality, accessible care. This position serves as a critical link between the Enterprise and its payer partners, ensuring that managed care agreements align with organizational goals for growth, value-based care, and operational excellence.

Job Description

• Executes the process to complete required payer contracts/amendments /renewals as assigned.
• Meets independently with peers and payers to further organizational objectives.
• Makes recommendations on financial terms and contract language by collaborating with Payer Analytics, Legal and other internal stakeholders to create comprehensive rate proposal/impact deliverables (includes financial analysis, contract language/redline).
• Ensures complete and accurate implementation of all fully executed contract documents.

Education and Experience

• Bachelor’s Degree in Business, Health Administration, Finance, or related field, required.
• Master’s Degree Business, Health Administration, Finance, or related field, preferred.
• 5 years progressive experience in managed care contracting or payer relations within a complex healthcare
  organization, required. and
• 5 years Proven success in negotiating payer agreements, developing reimbursement strategies, and managing payer
  relationships, required.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Thomas Jefferson University Hospitals, Inc.

Primary Location Address

1101 Market, Philadelphia, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.    

Jefferson is committed to providing equal educa­tional and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status. 

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

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