The Coordinator of Contract Building and Maintenance will be responsible for the financial analysis of contracts post contract negotiations including the auditing of contract builds in the designated contract management system, identifying reimbursement opportunities and assisting in the building of all health plan contracts for modeling. The position works with other members of the system managed care department as well as regional management in finance, the business office and case management to successfully report and monitor comprehensive indicators of profitability and payment accuracy of managed care contracts for CHRISTUS Health.
- Mission/Ministry --Model behavior consistent with the Mission, Core Values and Vision of CHRISTUS Health
- Business Literacy --Understands the challenges and opportunities within the health care environment and identifies and develops actions to address both.
- Interpersonal Relationships -- Promotes collaboration and collegiality, open communication and team spirit
- Continuous Improvement -- Develops a working knowledge of CHRISTUS facilities; processes, systems and performance in order to identify methods to improve system performance.
- Performance Effectiveness -- Performs quality work and by examples inspires others to do the same.
- Customer Focus -- Seeks feedback from both internal and external contacts to improve performance. Considers the impact of actions on customer/patients.
- Change Leadership: Demonstrates the ability to lead a group, focusing and energizing them to work together for change. This includes articulating the CHRISTUS vision, managing resistance, and the perseverance to follow through to completion.
- Collaboration: Collaborative leadership style, comfortable seeking counsel without losing decisiveness or the ability to take action and inspire others to take action.
- Shaping the CHRISTUS Vision: Builds or adapts organizational structures and relationships to accomplish and improve performance. This includes reorganizing people and organizational systems, processes, procedures, communications and reporting relationships.
- Information Seeking: Focuses on current, objective realities, and on using an understanding of these realities to make decisions for the organization. Understands and gives appropriate emphasis to the long term consequences of these decisions.
- Performance Excellence: Exercises personal drive and initiative to measure and improve organizational performance, focusing attention on working within the financial and business realities of the organization.
- Integration of Ministry Values: Demonstrates commitment to incorporating the traditions and values of the Catholic health ministry into organizational decisions.
- Care for Poor and Vulnerable Persons: Possesses an underlying concern for justice and fairness in societal relations which is expressed, within the leadership role, by taking initiative to serve the needs of the disadvantaged.
- Spiritually Grounded: Understands that leadership is more than a role within the organization and has the ability to call upon the spiritual resources of the Catholic faith tradition, personal faith and the faith of co-workers to lead the organization to accomplish its vision.
- Integrity: Demonstrates the courage to act and to take risks consistent with one's values and the values and philosophy of CHRISTUS.
- Dignity of Person: Nurtures an open, equitable and values-based work environment that is filled with a spirit of hope and wholeness.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
- Audit new and existing contracts in designated contract management system to ensure accuracy of rates and structure.
- Apply contract terms and conditions to internal CHRISTUS facility processes and health plan payment strategies to improve reimbursement and help reduce overall aging of managed care receivables.
- Produce analytical reports using Horizon Performance Manager (HPM), Crystal, Horizon Business Insight (HBI) or other database to identify payment variances and quantify financial impact of payment problems or reimbursement discrepancies.
- Develop a corrective action plan to address the root cause of the systematic profitability and/or payment variance problem identified in the above mentioned reports.
- Participate, as needed, in managed care operational meetings or in-services with payers to address trends identified in reports.
- Assist in building of contracts in the designated contract management system.
- Build solid working relationships and a good rapport with payer representatives and internal customers.
- Participate, if requested, on hospital denial, underpayment and revenue cycle projects.
- Assist with special projects regarding CDM pricing, under/over payments, system implementations and business office education.