Develops complex contractual reimbursement analysis to support contract negotiations performed by Administrative Director of Managed Care and Payer Strategy. Provides analytics to support the Managed Care objectives of NCHS.
Job Specific Duties
Manages contract documentation process.
Prepares and analyzes contract proposals by evaluating financial impact.
Supports contract negotiations with financial analysis.
Conducts contract audits to identify payer behavior and areas of opportunity.
Obtains and performs regular fee schedule audits of Managed Care Contracts to ensure appropriate level of reimbursement is applied.
Nicklaus Children’s Health System, is the region’s only healthcare system exclusively for children. In addition to Nicklaus Children’s Hospital and a growing number of outpatient centers located throughout the tri-county area, the health system includes Nicklaus Children’s Hospital Foundation, the organization’s fundraising arm; Nicklaus Children's Pediatric Specialists, a nonprofit physician practice subsidiary; a management services organization, and an ambulatory surgery center. Our vision is to be where the children are. Ultimately, this means being there through all stages of health and life, both physically and emotionally. To be a trusted partner to children and their families, not only in times of illness, but throughout their life journey. Our mission is to inspire hope and promote lifelong health by providing the best care to every child.