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Job Details

Manager Payer Relations

Experience
5 yrs required

Location
Nashville, TN, United States

Posted on
Sep 24, 2020

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Profile

Manager, Payer Relations
The candidate will serve as a manager for firm’s Coordination of Benefits (COB) product. Assists the Solutions Leader with the daily oversight and management of attorneys and EDI specialists. The Payer Relations team is charged with negotiating data rights with commercial insurance companies. These data rights enable to COB product to receive the submission of eligibility data to **MEMBERS ONLY**SIGN UP NOW***. and the transfer of Medicaid claims to the insurance companies. Act with expertise as the organization’s authority on COB regulations using clear and effective verbal and written communications skills to express ideas, request action and formulate plans or policies. Builds a robust understanding of external customer needs (user focused, jobs to be done) and strong customer relationships. Will direct and support the day to day activities of assigned staff, who are primarily located in Nashville TN. Build partnerships and works collaboratively with others to meet shared objectives. This includes working with cross functional teams within firm such as COB operations, enterprise IT, account management, and data management teams for other business units. Accomplish staff results by communicating job expectations; planning, monitoring, and appraising job results; coaching, counseling, and implementing corrective action steps when necessary; developing, coordinating, and enforcing systems, policies, procedures and productivity standards. Ensure team goals are met; develop strategies and schedules for meeting stated goals. Develop policies and procedures, job aids, reference materials for team workflows. Monitor and review the team members’ workload and productivity; provide direction and backup as needed. JD Degree Preferred. Should have 2+ years experience in supervisory/leadership role. Must have 5+ years in relevant work experience in Healthcare.

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