About this opportunity
Beth Israel Lahey Health lists this Payor Operations Specialist opportunity in wakefield, Massachusetts. Review the employer’s description below for duties, qualifications and application requirements.
Job description
When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.
nPosition Summary:
nReporting to the Director, Payor Operations, the Payor Operations Specialist, serves as a key member of the team. BILHPN provides support within our value based care agreements aimed at providing high quality care that is cost effective. The Payor Operations Specialist directs and manages Payor deliverables within our value based contracts. Serving Payor value based contract needs includes deliverable insight, contract opportunity evaluations, developing strong Payor partnerships, navigating and notification of Payor communications, consultation, Payor programs accountability, evaluations, and refinements.
nJob Description:
nEssential Duties & Responsibilities including but not limited to:
nPartners with Director, Payor Operations, to provide internal consultative direction related to Payor opportunity and needs within our contracts
nLeads Payor deliverable oversight, including tracking and sending of deliverables and facilitation of deliverable needs
nwhere applicable
nDevelop and optimize integration, in collaboration with respective teams, of applicable Payor needs and considerations
nacross BILHPN
nPerform evaluations and gap analyses regarding Payor requirements to appropriately develop interventions that are
nneeded to support contract requirements
nGrow and uphold Payor relationships, including Payor accountability, with Payor partners
nNavigate, develop, implement, and maintain – in partnership with Director, Payor Operations - processes on bi-directional
ncommunication avenues needed for Payor alerts, notifications, deliverables, or training
nCreate action plans, roadmaps, and business cases for opportunity within the Payor space that needs to be addressed to
nperform appropriately
nMaintains inventory of Payor deliverables
nManages Payor deliverables through the full lifecycle – planning, execution, monitoring, and completion
nAttends Payor specific meetings, including gathering of and updating materials
nSynthesizes and reviews Payor reporting packages to ensure BILHPN stakeholders are receiving what they need, with
nrecommendations being sought through if adjusts are needed
nRefines current processes related to Payor requirements
nAssists with compilation of materials related to Payor requirements
nLeads communication efforts with Payor stakeholders
nDevelop and maintain strong vendor relationships that support success within contracts
nProactively support addressing impacts, barriers, and risks to deliverables
nCommunicates content information appropriately to stakeholders, local leaders, administrators, support staff, BILHPN
nteams, and providers
nBuild and maintain working relationships with internal teams, administrators, vendors, revenue cycle, Payors, practice
noperations, and provider community to foster collaboration and partnership in driving meaningful change within payor
noperations divisional areas
nOrganizational Requirements:
nMaintain strict adherence to the Lahey Health Confidentiality policy. Maintain strict adherence to all BILH and BILHPN Policies.
nMaintain courteous and effective interactions with colleagues and providers and stake holders. Demonstrate an understanding of the job description, performance expectations, and competency assessment. Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to customer service standards. Participate in departmental and/or interdepartmental quality improvement activities. Participate in and successfully completes Mandatory Education. Perform all other duties as needed or directed to meet the needs of the department.
nMinimum Qualifications:
nEducation: A Bachelor’s Degree in Healthcare Management, Administration, Public Health, Business Administration, or other related functional area is required.
nLicensure, Certification & Registration: N/A
nExperience: 1-3 years of experience with Payor relationships, contract elements within value based care, or other related field within a healthcare environment required. Experience with strategy and opportunity evaluation a plus. · Ability to make decisions that are guided by precedents, policies and objectives. Regularly makes decisions and recommendations on issues affecting a department or functional area. · Ability to set goals and priorities for functional area. May make recommendations for department policies, practices and programs. Director provides broad guidance and overall direction. · Ability to communicate complex information in English effectively in writing to all levels of staff, management and external customers across functional areas. · MS Office applications with advanced skills in Word, PowerPoint, Excel and Outlook required · Ability to verbally communicate complex concepts in English and escalate sensitive situations and conflicts · Ability to act as a team leader for Payor deliverable initiatives, creating a collaborative and respectful team environment and improving workflows. Results may impact the operations of one or more departments. · Ability to provide a high level of customer service · Strong organizational skills and the ability to articulate complex workflows and processes · Experience with fast paced, high-visibility initiatives · Ability to work with varying teams and communicate needs
nSkills, Knowledge & Abilities: Microsoft Word, Excel, Powerpoint, SmartSheet (preferred)
nKey Relationships:
n1 BILHPN Ops Teams
n2 BILHPN Clinical Excellence Teams
n3 Local Care Unit Leaders .
n4 Vendor Contacts (as applicable)
n5 Practice/Local Care Unit Staff
n6 Providers
n7 HMFP Leaders
n8 BILH Revenue Cycle
n9 APG Leaders
n10 BILHPC Leaders
n11 Care Retention & Access Leaders
nScope/Impact Statement:
nWork Schedule: Indicate either Yes or No as appropriate. Hours of work may be subject to change based upon the needs of the business/department.
nOn Call: No Shift Rotation: No Weekends: No
nPhysical Requirements & Environment: Required
nFor each category, select ONE option from choices below by placing an X in the space to the left of the entry.
nMental and Visual Attention Required
na) The position requires basic mental and visual attention much or all of the time
nb) X The position requires periods of concentrated mental and visual attention.
nc) The position requires a high degree of mental and visual concentration.
nPhysical Exertion
nWeight
nd) X Nature of work requires lifting or moving light weight (up to 20 pounds).
ne) Nature of work requires lifting or moving medium weight (over 20 and up to 75 pounds).
nf) Nature of work requires lifting or moving heavy weight (over 75 pounds).
nDexterity
ng) X Flow of work and character of duties require average manual coordination.
nh) Flow of work and character of duties require above average manual coordination.
ni) Flow of work and character of duties require high manual coordination.
nRange of Motion
nj) X Duties require average range of motion.
nk) Duties require above average range of motion.
nl) Duties require high range of motion.
nPhysical Conditions
nm) Performance of duties allows for variation in positioning and tasks.
nn) X Performance of duties requires remaining in position for prolonged periods of time.
nRepetitive Motion
no) Assignments require occasional repetitive motion.
np) X Assignments require frequent repetitive motion.
nq) Assignments require constant repetitive motion.
nWorking Conditions
nr) X Working conditions include minimal exposure to elements such as odor, noise, dust, chemicals, temperature extremes or airborne pathogens.
ns) Working conditions include occasional exposure to elements such as odor, noise, dust, chemicals, temperature extremes or airborne pathogens.
nt) Working conditions include continuous exposure to elements such as odor, noise, dust, chemicals, temperature extremes or airborne pathogens.
nExposure to Hazardous Materials
nu) X Performance of duties generally does not involve exposure to hazardous materials.
nv) Performance of duties occasionally involves exposure to hazardous materials.
nw) Performance of duties frequently involves exposure to hazardous materials.
nPatient Care Conditions (select ALL that are applicable)
nx) Position entails exposure to blood and body fluids, standard precautions must be used.
ny) Assignments include transporting, transfer and positioning of patients.
nz) Incumbent must be continuously prepared to prevent a patient fall.
nSensory Requirements (select ALL that are applicable)
naa) Performance of duties requires the ability to discern and identify colors
nbb) Performance of duties requires the ability to discern sharp from dull and hot from cold
ncc) Performance of duties requires the ability to hear soft and loud noises
nPatient Care/Patient Contact Designation (check only one of the items listed below)
n_ Position has a direct impact upon health outcomes of the patient.
n_ Position facilitates the process that may impact patient access to services.
nX No patient care/contact, and does not facilitate the patient care process or directly impact health outcomes.
nThis Job Description is intended to describe the general nature and level of work being performed by people assigned to this classification. It is not intended to be construed as an exhaustive list of all responsibilities, requirements, duties and skills required of personnel so classified. Additional duties and responsibilities that are specific to the Department or Unit are identified and maintained by the Manager as an Addendum to the Job Description.
nPay Range:
n$79,040.00 USD - $93,600.00 USD
nThe pay range listed for this position is the annual base salary range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law.
nAs a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.
nMore than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.
nEqual Opportunity Employer/Veterans/Disabled
Worksite address
wakefield, MA, 01880, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.