Managed Care Contracting Manager - Virginia Oncology Associates
Norfolk, VA 23502
About the Job
Overview:
Virginia Oncology Associates, the largest group of medical professionals in Hampton Roads and Northeast North Carolina devoted exclusively to cancer care and blood disorders, has an exciting opportunity for a Managed Care Contracting Manager to support the practice from our Business Office in Norfolk.
***Please take this quick survey once you've submitted your resume to complete the application process: Managed Care PI Survey Link
Responsibilities:- Assists Cellular Therapy Team in evaluating and developing patient insurance agreements related to contract language, reimbursement rates and other proposal components.
- Supports the Cellular Therapy Team in assisting with insurance authorization issues related to Transplant and CAR-T therapy procedures.
- Develops and maintains policies and processes related to cell therapy authorization, agreement negation and insurance requirements.
- Communicates and contracts with insurance providers related to negotiation of managed care contracts within the practice.
- Works with outside vendors to assist as needed with insurance denial support.
- Monitors payments for cell therapy post procedure to verify payment received according to agreement and works with appropriate business office personnel to address any concerns identified.
- Tracks vendor charges against services provided for cell therapy procedures performed.
- Liaison with the RBO to share patient or insurance specific contract agreements to ensure correct billing protocol in place per agreement.
- Provide the RBO with product reimbursement information and notify of new therapies for VOA to allow for set-up time in Athena for prompt billing and denial support.
- Assists finance team with developing and maintaining monthly analytics to support monthly financial statements specific to cellular therapy product line.
- High School Diploma required.
- Bachelor’s degree preferred, preferably in Healthcare Administration, Business Administration, or Insurance and Risk Management.
- Minimum 7 years required of managed care, contract negotiations, or end to end revenue cycle experience
- Proficiency with Microsoft Office (Excel, Word, PowerPoint).
- Strong verbal and written communication skills.
- Strong analytical skills.
- Must be willing to travel between sites as needed.
Source : Virginia Oncology Associates