MinnetonkaRecruiter Since 2001
the smart solution for Minnetonka jobs

Payment Intent Policy Manager

Company: Medica
Location: Minnetonka
Posted on: March 26, 2020

Job Description:

The Payment Intent Policy Manager is responsible for the overall strategic and tactical activities related to identifying, developing, implementing and supporting Medica's provider reimbursement policies.--The Payment Intent Policy Manager performs critical functions to manage the end-to-end policy process which include: research, data analysis, policy development, implementation, communication, training, and issue resolution. By evaluating current and changing industry recognized reimbursement methodologies the Payment Intent Policy Manager ensures consistent, accurate reimbursement to providers.--The Payment Intent Policy Manager serves the critical function of delivering to Medica's customers solidly sourced reimbursement policy based upon recognized industry standard sources (i.e. CMS, AMA, CPT, national and community payers) to ensure payment methodologies are defensible and consistent with Medica's reimbursement philosophy.----The Payment Intent Policy Manager works with the Manager of Payment Intent, Sr. Director Internal Audit, co-chairs of the Reimbursement Policy & Strategy Committee, and other Medica leaders to identify, assess, recommend and implement reimbursement strategies and process improvements.----The Payment Intent Policy Manager performs audits and analyzes coding and claims data to ensure payment outcomes are executed on multiple claims platforms.--Additional Responsibilities:Provides guidance and develops educational tools to meet the needs of internal and external key stakeholders.Facilitates and provides guidance to interdepartmental workgroups based on policy strategies and collaborates on broad Medica initiatives requiring expertise in provider reimbursement methodologies.--Serves as a reimbursement policy subject matter expert on various internal committees and as the Medica representative to external state committees working to standardize administrative transactions for providers and payers focused on reducing health care costs.----QualificationsBachelor's degree preferred. Strong coding experience may be considered in lieu of a Bachelor's degreeHealth Information Management or Nursing with coding/reimbursement experience7+ years of work experience beyond degree3+ years experience related to professional billing and health care reimbursement methodologiesKnowledge of CPT, HCPCS, and ICD 10 diagnosis codes and coding principlesCoding certification (CPC, CPC-P, CPC-H, CCS or CCS-P) or the completion of such certification within one year of employment is required.Experience with hospital/facilities coding (UB-04), revenue codes, DRGs, APCs and ICD 10 diagnosis and procedural codes desirable; those having at least one of the 3+ years of experience in both professional and facilities coding is a plus.RN/LPN nursing degree/experience desirableHMO and claims experience helpful--Skills & AbilitiesStrong understanding and knowledge of coding and reimbursement methodologyFunction as a SME for reimbursement policiesAble to analyze and translate data (to determine financial impact) and develop recommendationsStrong technical writing and verbal communication skillsAbility to prepare and develop and diverse information into effective presentationsStrong computer software skills: Microsoft Office Suite including Access, Excel, PowerPoint, Visio, and WordStrong internet research skillsPossess excellent time management and prioritization skills in order to meet multiple deadlines; comfortable working in a high-paced environmentExperience leading/facilitating process improvement teamsCollaborative problem solving skills to identify and implement effective solutions

Keywords: Medica, Minnetonka , Payment Intent Policy Manager, Executive , Minnetonka, Minnesota

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Executive Jobs


Director, Dev-Behavioral Peds
Description: The teaching program involves care for children with autism, attention and learning disorders, and a range of developmental and behavioral disorders.-- The University serves
Company: Childrens Hospital Association
Location: Minneapolis
Posted on: 04/6/2020

Sr. Industrial Construction Project Manager - Minneapolis, MN
Description: CONSTRUCTION PROJECT ENGINEER SANTA ROSA, CA Ground Up Commercial Building Construction General Contractor Opening: Construction Project Engineer Location: Santa Rosa, CA North Bay Area Prestigious (more...)
Company: TJG Engineering
Location: Minneapolis
Posted on: 04/6/2020

Director, People Operations
Description: The Director, People Operations drives achievement of Bright's business objectives by providing comprehensive human resources services and processes.-- This person leads effective operations of the people (more...)
Company: Bright Health
Location: Minneapolis
Posted on: 04/6/2020


Director, Product Development
Description: This position will be a member of the overall R D leadership team and is responsible for leading the development and support of the Company's radiofrequency RF catheter ablation devices.-- The Director,-- (more...)
Company: AtriCure, Inc.
Location: Minneapolis
Posted on: 04/6/2020

RN Case Manager - Hospice- Ft
Description: DescriptionHCR ManorCare is a wholly-owned subsidiary of ProMedica, a mission-based, not-for-profit integrated healthcare organization. HCR ManorCare operates the post-acute division of ProMedica and (more...)
Company: HCR ManorCare Inc.
Location: Saint Paul Park
Posted on: 04/6/2020

Strategy Product Manager - Enterprise Application Hosting Services
Description: Job Description Important Note: During the application process, ensure your contact information email and phone number is up to date and upload your current resume when submitting your application for (more...)
Company: Wells Fargo Bank
Location: Minneapolis
Posted on: 04/6/2020

Medical Affairs Executive Director (Ecosystem)
Description: The Medical Affairs Executive Director MED is a cross portfolio role,-- responsible for co-creating and driving an overarching medical strategy across a local healthcare region with the goal of improving (more...)
Company: Genentech
Location: Minneapolis
Posted on: 04/6/2020

Director of Business Development
Description: As Director of Business Development DBD for the Mid-West, you will lead new Dining Services business development initiatives and processes within an 8 state region. Reporting directly to the Associate (more...)
Company: Aramark Uniform Services
Location: Minneapolis
Posted on: 04/6/2020

Global Product Manager 4
Description: Job DescriptionImportant Note: During the application process, ensure your contact information email and phone number is up to date and upload your current resume when submitting your application for (more...)
Company: Wells Fargo
Location: Minneapolis
Posted on: 04/6/2020

Warehouse Manager Trainee
Description: Warehouse Manager Trainee br br From 20 to 25 per hour br br Opportunity for annual bonuses over 6,000 br br Minnesota Branch br br 3325 Heiser St. Hudson, WI 54016 br br Good times (more...)
Company: ULINE
Location: Hudson
Posted on: 04/6/2020

Log In or Create An Account

Get the latest Minnesota jobs by following @recnetMN on Twitter!

Minnetonka RSS job feeds