*ETHOS LABORATORIES* – Newport, KY
LOCATION: This position will be remote, after initial training
HOURS: Monday – Friday, 8:30AM – 5:00PM
EDUCATION AND EXPERIENCE:
- Bachelor’s degree in a related field (required) OR
- Equivalent work experience on Payer and Provider side (required)
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
- Working knowledge of various billing and payers systems
- Performs portfolio financial analysis on contract activity for laboratory necessary to support the accuracy and profitability of managed care contracting initiatives
- Prepares financial analysis, performs contract modeling and assists in developing the proposal
- Aggressively participates in the identification, development, negotiation, and management of provider payor agreements
- Manage complex contracting and negotiations for fee-for-service, value-based, pay for performance contracts and amendments
- Lead the rate and language negotiation discussions with the payors
- Provide strategic leadership around negotiating contracts for closed networks
- Works with the Company’s Billing Office as needed when rates received by payors vary from the contract.
- Keep abreast of marketplace changes for payors, networks, reimbursement issues and changes in legislation or in guidelines at the state and federal levels
- Ensure contract files are in order and kept up to date and archived in compliance with records management policies and procedures
- Update internal partners on contracting efforts, needs, and process. Provide guidance and training for executed contracts
- Perform other duties as directed
- Three to five years contracting and negotiating experience involving complex healthcare delivery systems and organizations required
- Knowledge of Laboratory negotiation and contracting (preferred)
- Knowledge of complex reimbursement methodologies, including fee for value or incentive-based models strongly preferred
- Proven portfolio of strong client relationships where an immediate contracting impact can be realized.
- Experience with analyzing and reporting sales data in order to identify issues, trends, or exceptions to drive improvement of results and find solutions.
- Understanding and experience with hospital, managed care, and provider business models
- Excellent time management skills and the ability to prioritize work
- Attention to detail and problem solving skills
KNOWLEDGE, SKILLS, AND ABILITIES:
- Ability to communicate effectively, orally, and in writing
- Skill in completing assignments accurately, timely, and with attention to detail
- Ability to process and handle confidential information with discretion
- Work is performed during regular work hours, but may require evening and/or weekend hours to meet deadlines.