Contessa offers a unique opportunity for individuals interested in being part of an organization that is leading the country in redefining the way care is provided to patients. Contessa’s Home Recovery Care model brings all the essential elements of inpatient care to the comfort and convenience of a patient’s home. The model enables provider organizations and health plans to deliver high-quality, safe and affordable care to patients with non-life-threatening conditions. At Contessa, you will have the opportunity to make a direct impact on the lives of patients and be at the forefront of shaping a pioneering space in the health care industry.
About the Role:
Contessa’s Network team is accountable for driving Contessa’s partnerships with the nation’s leading hospitals, health systems, and payers. Our ambition is to position Contessa as the nation’s leading provider of hospital-level care in the home. The Director of Payer Engagement position is a critical member of this fast-paced team and will play a key role in the advancement of payer contracts, implementations, and relationships.
• Manage payer implementation and communication process including opportunity evaluation, implementation, performance monitoring, and recordkeeping to retain and enhance viable financial and market positions
• Serve as an active account manager for Contessa Health with the contracted payer to retain a strong relationship and promote proactive breakdown resolution
• Coordinate priorities and projects with payer partners and Contessa internal resources including clinical, operations and executive teams
• Maintain contracting calendars to ensure adherence to key contract dates and timelines related to contract requirements, adjustment and/or renewals
• Serve as primary contact with select health plan partners post implementation, to manage existing programs and identify/evaluate potential strategic expansion opportunities
• Provides the regularly scheduled reporting package to local and national payer partners for joint operating committee meetings
• Responsible for addressing operational payer issues (i.e. claims/invoice payment, authorization issues)
• Oversees payer-based analytics and service level agreement performance tracking for daily consumption by clinical, operations and executive teams
• Serve as corporate resource related to managed care contracts for training, education, strategy, and business development purposes
• Maintains confidentiality of patient information and business trade practices
• Conforms to all applicable company policies and procedures
• Performs other related duties as assigned
• BA/BS degree, MBA or MHA preferred
• 8+ years working experience in the healthcare industry specifically in a payer setting
• Project management experience preferred
• Analytical experience preferred
• Authorization/Utilization Management experience
• Working knowledge of billing and claims processing
• Highly proficient all Microsoft Office products
Our team members are our greatest asset. That’s why you’ll find that Contessa has built a culture around trust, open communication, and a unified desire to change the way healthcare is being delivered. It’s important to us that you like your job, are motivated by the work you do every day and feel supported by leadership. Contessa offers a generous compensation and benefits package, a strong belief in a healthy work-life balance, and great opportunities for career growth.