Payer Relations Contracts Consultant

Allina Health Systems
US - Minnesota - Minneapolis
January 2, 2025
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Number of Job Openings Available:

Date Posted:

December 26, 2024

Department:

16001461 Payer Relations & Contracting

Shift:

Day (United States of America)

Shift Length:

8 hour shift

Hours Per Week:

Union Contract:

Non-Union-NCT

Weekend Rotation:

None

Job Summary:

Allina Health is a not-for-profit health system that cares for individuals, families and communities throughout Minnesota and western Wisconsin. If you value putting patients first, consider a career at Allina Health. Our mission is to provide exceptional care as we prevent illness, restore health and provide comfort to all who entrust us with their care. This includes you and your loved ones. We are committed to providing whole person care, investing in your well-being, and enriching your career.

Key Position Details:

The Contract Consultant serves as an interface between health plans and Allina business units to coordinate efforts in the evaluation, prioritization, and resolution of service issues. Develops communications and engages impacted staff regarding health plan policy and procedure changes by monitoring newsletters and other publications.

Monitors contractual obligations working closely with Directors and Contract Managers to ensure compliance. Supports assessment of the impact of contract terms to business units, advocates for changes into agreements where necessary to support administrative simplification.

Researches escalated claims issues to determine whether claims processed in accordance with health plan agreement; requires understanding of how to read a claim, basic coding, payment methodologies, and application of health plan coverage policies.

Supports Directors and Contract Managers who lead most health plan negotiations. This role leads contracting efforts for single case and county agreements. Leads the evaluation of new payer agreements.

This position has broad visibility across many service areas and accountability as a team player with various levels within the organization.

Serves as an interface between payers and company business units in the coordination of service delivery. Maintains awareness, develops communications and engages impacted staff regarding health plan policy and procedure changes by monitoring newsletters and other publications.

Principle Responsibilities

Interface for service delivery
- Monitors contractual obligations working closely with designated directors and contract managers to ensure compliance.
- Supports assessment of the impact of the contract terms to business units and advocates for changes into agreements where necessary to support administrative simplification.
- Researches escalated claims issues to determine whether claims are processed in accordance with the health plan agreement.
Business development
- Assists in the development of strategies to improve overall payer performance.
- Leads the evaluation of new payer agreements.
- Leads the contracting efforts for single case and county agreements.
Other duties as assigned.

Required Qualifications

Bachelor's degree in Finance, Business Administration Management or related field
2+ years of business experience
Understanding of how to read a claim, basic coding, payment methodologies and application of health plan coverage policies

Preferred Qualifications

Health care experience with an understanding of billing and payment methodologies

Physical Demands

Sedentary:
Lifting weight up to 10 lbs. occasionally, negligible weight frequently

Pay Range

Pay Range: $34.83 to $47.74 per hour The pay described reflects the base hiring pay range. Your starting rate would depend on a variety of factors including, but not limited to, your experience, education, and the union agreement (if applicable). Shift, weekend and/or other differentials may be available to increase your pay rate for certain shifts or work.

Benefit Summary

Allina Health believes the best way to provide safe and compassionate care for our patients is by nurturing the passion of those who care for them. That's why we devote extraordinary resources to help you grow and thrive - not only as a professional but also as a whole person. When you join our team, you have access to a wealth of valuable employee benefits that support the total well-being - mind, body, spirit and community - of you and your family members.

Allina Health is all in on your well-being. Because well-being means something different to everyone, our award-winning program provides you with the resources you need to help you navigate your personal journey. This includes up to $100 in well-being dollars, dedicated well-being navigators, and many programs, activities, articles, videos, personal coaching and tools to support you on your journey.

In addition, Allina Health offers employee resources groups (ERGs) - voluntary, employee-led groups that serve as a resource for members and organizations by fostering a diverse, inclusive workplace aligned with the organization's mission, values, goals, business practices, and objectives. Allina Health also engages employees in various community involvement and volunteering events.

Benefits include:

Medical/Dental
PTO/Time Away
Retirement Savings Plans
Life Insurance
Short-term/Long-term Disability
Paid Caregiver Leave
Voluntary Benefits (vision, legal, critical illness)
Tuition Reimbursement or Continuing Medical Education as applicable
Student Loan Support Benefits to navigate the Federal Public Service Loan Forgiveness Program
Allina Health is a 501(c)(3) eligible employer

*Benefit eligibility/offerings are determined by FTE and if you are represented by a union.

Read the full job description and apply online on the recuiter's web-site

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