UW Medicine’s mission is to improve the health of the public by advancing medical knowledge, providing outstanding primary and specialty care to the people of the region, and preparing tomorrow’s physicians, scientists and other health professionals. UW Medicine owns or operates Harborview Medical Center (HMC), Northwest Hospital & Medical Center (NWH), Valley Medical Center (VMC), UW Medical Center (UWMC), a network of UW Medicine Neighborhood Clinics (UWNC) that provide primary care, UW Physicians, UW School of Medicine, Airlift Northwest, and other owned, operated or affiliated entities as appropriate. In addition, UW Medicine shares in the ownership and governance of Children’s University Medical Group and Seattle Cancer Care Alliance a partnership among UW Medicine, Fred Hutchinson Cancer Research, and Seattle Children’s.
UW Medicine Contracting & Payer Relations has an outstanding opportunity for a Payer Contracts Manager. You will be responsible for assuring that healthcare payer contracts are drafted, edited, managed, and maintained in a manner that is fiscally responsible and compliant with legal, regulatory, and UW Medicine standards. Serve as a primary reviewer and drafter of payer contract language. You will be the primary support to the Director of Contracting with regard to contract language for all UW Medicine department payer contract negotiations.
Contract Review, Editing, & Drafting: Ensure that the terms of all Contracting and Payer Relations contract documents are complete, advantageous, prudent, and compliant with UW Policy. Work with legal and the payer to assure mutual understanding and complete clarity in the written document.
Record-keeping: Ensure Contracting and Payer Relations related contract files are in order and kept up to date, and archived in compliance with records management policies and procedures.
Policies & Procedures: Create policies and procedures manual sections; comply with policies and procedures; orchestrate staff training.
Regulatory Requirements: Gain and maintain knowledge of all applicable regulatory requirements for contracts, including Office of Insurance Commissioner and Healthcare Authority WACs, Medicare/CMS Regulations, and ERISA, as well as UW/UW Medicine policy.
Department Liaison: Serve as liaison with UW and UW Medicine and its individual entities, including Compliance, Risk Management, the AAG & Attorney General’s Office, Office of General Counsel, Office of Medical Staff Appointments, Chief Medical Officer, CMO's office, Hospital and Department Administrators, Patient Financial Services, Vice Presidents, and Quality Improvement.
Contract Renewals: Maintain work plan of contract renewal schedules, assist in establishing negotiation timelines, and maintain schedule to assure the Department may sufficiently prepare for and address each contract in time for renewal or anniversary, allowing adequate time for the negotiation process. Maintain a schedule to track and assure compliance with all deliverables in each payer contract, including delegated credentialing contracts and any regulatory addenda for all agreements.
Perform other duties as assigned.
Master's degree in Healthcare Administration, Business Administration, or related field.
Four to five years of contract language authoring and redlining experience to include healthcare/managed care payer contract redlining, drafting, and management.
Experience with creative and complex healthcare reimbursement methodologies.
In depth knowledge of Medicare, Medicaid, and Washington state managed care contracting regulations.
Excellent verbal and written communication skills.
High attention to detail and effective organizational skills.
Ability to effectively and efficiently manage a busy workload of multiple tasks and projects.
Familiarity with local managed care market.
Experience/familiarity with value-based contracting.
Masters degree, JD, or other advanced degree preferred.
Familiarity with contract modeling software and analytics.
Participation in HFMA, ACHE, MGMA, or other healthcare professional society.
Founded in 1861, the University of Washington is one of the oldest public institutions in the west coast and one of the preeminent research universities in the world. The University of Washington is a multi-campus university comprised of three different campuses: Seattle, Tacoma, and Bothell. The Seattle campus is made up of sixteen schools and colleges that serve students ranging from an undergraduate level to a doctoral level. The university is home to world-class libraries, arts, music, drama, and sports, as well as the highest quality medical care in Washington State and a world-class academic medical center. The teaching and research of the University’s many professional schools provide undergraduate and graduate students the education necessary toward achieving an excellence that will serve the state, the region, and the nation. As part of a large and diverse community, the University of Washington serves more students than any other institution in the Northwest.