Summary

This position supports activities of payor contracting and analysis for the Valley Health System. This position assists with enterprise-wide managed care contracting initiatives through analysis of claim and denial/payment trends and provides oversight of payer contract compliance for the system. This position is also a key resource to system stakeholders on new regulatory and legislative developments pertaining to the Federal Price Transparency and the No Surprises Act legislations. The position provides analytical support to other areas within the system (VMG, Population Health, ColigoCare, etc.) as it pertains to revenue forecasting, contract modeling, denial and payment variance analysis and trends. This position also serves as a one of the key subject matter experts for the system for any education related to insurance industry changes, managed care regulation, and impactful payer policies/protocol changes.

Job description

Position Summary

This position supports activities of payor contracting and analysis for the Valley Health System. This position assists with enterprise-wide managed care contracting initiatives through analysis of claim and denial/payment trends and provides oversight of payer contract compliance for the system. This position is also a key resource to system stakeholders on new regulatory and legislative developments pertaining to the Federal Price Transparency and the No Surprises Act legislations. The position provides analytical support to other areas within the system (VMG, Population Health, ColigoCare, etc.) as it pertains to revenue forecasting, contract modeling, denial and payment variance analysis and trends. This position also serves as a one of the key subject matter experts for the system for any education related to insurance industry changes, managed care regulation, and impactful payer policies/protocol changes.

Education

Bachelor's degree in economics, business administration, health care administration or related subject is required. MBA or MHA degree preferred.

Experience

A minimum of two years' experience with payor or provider contracting in a health care setting, knowledge of the healthcare industry and payor reimbursement methodologies

Special Skills

Excellent analytical skills, with attention to detail and accuracy required. Strong communication and interpersonal skills required. Excellent written, organizational, and critical thinking skills required.

Requirements

Bachelor's degree in economics, business administration, health care administration or related subject
MBA or MHA degree preferred
Minimum of two years' experience with payor or provider contracting in a health care setting
Knowledge of the healthcare industry and payor reimbursement methodologies
Excellent analytical skills, with attention to detail and accuracy
Strong communication and interpersonal skills
Excellent written, organizational, and critical thinking skills

Benefits

Medical, Dental & Vision
Group Term Life & AD&D
Flexible Spending Accounts
Commuter Benefit Plans
Short-term & Long-term Disability
Whole Life Insurance
Legal Support
6 Paid Holidays
Paid Time Off
Wellness Time Off
Extended Illness
Retirement Plan
Tuition Assistance
Employee Assistance Program
Fitness Center Discount
Day Care Discounts

Company overview

The Valley Health System is an integrated healthcare network serving Las Vegas and Southern Nevada, operating as a subsidiary of Universal Health Services, Inc. (UHS). Established in 1979, the system has grown to become the largest provider of healthcare services in Southern Nevada, serving over two million residents across the region. The network comprises six acute care hospitals, two specialty hospitals, seven freestanding emergency departments, and numerous outpatient facilities and physician practices. Key hospitals include Centennial Hills Hospital Medical Center, Henderson Hospital, Spring Valley Hospital Medical Center, Summerlin Hospital Medical Center, Valley Hospital Medical Center, and West Henderson Hospital. The system offers comprehensive medical services including emergency care, cardiovascular services, neurosciences, maternity and women's health, orthopedics, oncology, behavioral health, and specialized programs in stroke and heart attack care. All Valley Health System hospitals are accredited by The Joint Commission and consistently earn national recognition for quality care, with certifications from the American Heart Association and American Stroke Association. The organization employs over 9,000 healthcare professionals dedicated to providing patient-centered care while also serving as a teaching institution with graduate medical education programs and clinical training opportunities for future healthcare providers.