At ChristianaCare, we serve as our neighbors as respectful, expert, caring partners in their health. We do this by creating innovative, effective, affordable systems of care that our neighbors value. Are you an authority regarding contract negotiation, implementation, compliance, and managing payer relationships? If you possess this desire and a background in payer and provider based reimbursement this is the opportunity you have been seeking!

ChristianaCare Benefits:

Incredible Work/Life benefits including annual membership to care.com, access to backup care services for dependents through Care@Work, retirement planning services, financial coaching, fitness and wellness reimbursement, and phenomenal discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets, etc.

We also provide tuition assistance for degreed programs. Our medical/dental/vision benefits are available to our caregivers on their first day of employment! And we offer two different mechanisms toward planning for your retirement, a 403(b) and a defined contribution plan.

As the leader of our Managed Care Contracting team you be responsible for providing contracting services, support and representation to managed care payors for all enterprise-wide entities,

The successful candidate is responsible for:

• Lead negotiations for designated contracts including but not limited to Dental, Vision, Skilled Nursing, Transplant, Direct to Employer contracts within the managed care contract portfolio
• Provide support to the negotiating team by evaluating draft contracts in compliance with company templates, reimbursement structure standards, and internal operational and clinical structures
• Collaborate with finance to develop and maintain each respective organization's financial contracting modeling system by ensuring contract rates are loaded and results are validated to enable the development and evaluation of various facility reimbursement models within the markets of DE, MD, PA, and NJ
• Collaborates with stakeholders across the organization including but not limited to; finance, legal, population health, clinical operations, etc.

Education and experience requirements:

• Bachelor's degree strongly preferred in Finance, Economics, Healthcare or Business related
• Minimum of six (6) years of provider-based reimbursement/contracting experience and/or payer-based reimbursement/contracting/payer relations experience through managed care reimbursement review/management, consulting, or population health management is required
• Understanding of provider contracting, payer policies and procedures and various reimbursement methodologies is required
• Proven track record of experience with Hospital, physician, ancillary, bundle payment and other revenue cycle types of reimbursement

ChristianaCare is one of the country's most multidimensional health systems, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs. Christiana Care includes an extensive network of outpatient services, home health care, medical aid units, three hospitals (1,300 beds), a Level I trauma center and regional centers of excellence in heart and vascular care, cancer care and women's health.

Working for Christiana Care offers the best of urban and suburban living with multiple housing options, excellent restaurants and entertainment venues, quality schools and a short driving distance to popular Delaware and New Jersey beaches. The location provides easy access to Washington, DC, Philadelphia and New York City - all within a short drive or train ride from Newark, DE.

EEO Statement: Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

UPDATE: ChristianaCare is committed to prioritizing the health and safety of our patients and caregivers. As we continue to meet the needs of our caregivers and our community through the COVID-19 pandemic, our commitment to health and safety requires that we take new steps to ensure a safe environment for medical care for our patients and a workplace that avoids preventable harm for our caregivers. For this reason, vaccination for COVID-19 is required for all caregivers at ChristianaCare and is considered a safety standard that is job-related and consistent with business necessity for all caregivers.