Director of Network Reimbursement

Director of Network Reimbursement

Director of Network Reimbursement

Date Posted 8/5/2011

Location Albuquerque, NM

Degree Required BS in Business

Min Salary $90,000.00

Max Salary $115,000.00

Job Type Full-Time Regular

Min Experience 5 Years

Position Id EB-1803676046

Job Description

There is currently an urgent need for an individual with stronghealth plan reimbursementexperience to join a stable organization on afull-timebasis. This is a terrific opportunity offering alucrative salary, great benefitsand other outstanding perks.

Responsibilities

· Develop and implement acomprehensive reimbursement programincluding financial, operational, correct coding, and compliance audits
· Developcorrect coding policiesand procedures for the health plan
· Direct the activities and administrative responsibilities of the Provider Reimbursement Department and any reimbursement audit function to ensure correct provider payment
· Establishstandards of performanceand determine that standards are met
· Establish and monitor a quality assurance program for the department
· Plan and conduct annual and ongoing training programs for reimbursement staff and provider officers
· Evaluate the reliability and integrity of financial and operational information
· Oversee compliance with reimbursement and contracting policies, plan, procedures, laws, and regulations

All candidatesMUSThave the following experiences to qualify for consideration

* PleaseDO NOT APPLYunless you have a Bachelor's Degreein Business(or a related field) and at least5 yearsof experience withhealth plan reimbursement
* Deep understanding ofprovider contractingandprovider relations, as well as correct coding
* Have the strategic capability to determine how to attract and pay providers in order to support the long-term strategy of the organization
* This role would manage5 direct reportsand previous management position is strongly preferred

If interested andQUALIFIED, please send resume inMicrosoftWord formatto: drewl@etechhi.com
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