Director, Provider Reimbursement and Contract Analysis- JHP

Minimum of 10 years’ progressive experience in a managed care setting/role with a comprehensive understanding of provider reimbursement, provider contracts, financial modeling and advanced claims analytics.

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than

part-time (including

per diem

colleagues, adjunct faculty, and Jeff Temps

), have access to medical (including prescription) insurance.

here

The Director, Provider Reimbursement and Contract Analysis is responsible for developing reimbursement strategies and methodologies, network reimbursement / financial analyses, and related reimbursement operations.

The position is responsible for oversight of all reimbursement functions for the HPP Pennsylvania provider network and future expansion markets.

Responsible for establishing reimbursement methodologies, strategies, and payment analysis for all provider types.

Responsible for the design and oversight of payment methodologies to providers representing more than $1B annually.

Develop reimbursement strategies and systems based upon a technical understanding of industry standards and innovative payment models, including specialized knowledge of Pennsylvania Medicaid and CMS Medicare payment methodologies.

Develop financial models to support network negotiations and payment system strategies, including relative rate benchmarking.