Providence Health & Services Manager - Payer Contracting Compliance in Renton, Washington
Providence is calling a Manager - Payer Contracting Compliance to Providence Health & Services in Renton, Washington.
Reporting directly into the VP Chief Compliance Officer Payer Contracting, the Manager Payer Contract Compliance will play an important role supporting the complex and dynamic interface between the insurance payers and PSJH. In this effort S/he will work closely with the payer contracting compliance team, contract negotiators, contract administration and operations team, ACO staff and stakeholders at state and federal regulatory agencies (e.g. California Department of Managed Health Care and CMS).
In this position you will:
Manage regulatory compliance activities for Providence’s accountable care organizations (ACO) and other value based care delivery arrangements.
Participate in the preparation of required regulatory compliance filings and reports, including all appropriate documentation.
Support the preparation of PSJH management reports related to payer contracting compliance activity.
Research, analyze, and communicate state and federal regulations in order to ensure stakeholders meet compliance obligations.
Support key payer contracting departmental activiites involving contract review, assessment of payer policies, and compliance with attestations.
Create trainings on policies and best practices for stakeholder entities.
Required qualifications for this position include:
- Bachelor’s degree in Business Administration or a related field
Preferred qualification for this position include:
Master's degree in Business Administration or related field
2 years experience in healthcare compliance, law practice (in house or firm) in health law or a related field
5 years experience in a large health system, payer or medical group compliance
Ability to analyze information gathered by investigation and report findings and recommendations
About the department you will serve.
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence Health & Services from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We offer a full comprehensive range of benefits - see our website for details
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Non-Clinical Lead/Supervisor/Manager
Req ID: 237473