Payer Relations & SCA Specialist (Remote)

Johns Hopkins HealthCare LLC; Baltimore (MD); Remote; USD 43.000 - 72.000; Vollzeit

Benefits dieser Stelle

Career growth

Collaborative environment

Paid Time Off

Tuition Reimbursement

Benefits package

Zusammenfassung

Johns Hopkins Health System in Baltimore is seeking a Finance professional to oversee Single Case Agreements (SCAs) and payer contract activities for contracted and non-contracted payors. You will coordinate SCA reviews, implement contracts, and guide internal staff on managed care workflows.

With a background in healthcare administration and payer relations, you will build relationships with payers and internal stakeholders, deliver education on SCA processes, and monitor contract performance

Qualifikationen

• Bachelor’s degree in business administration or healthcare administration required.
• Experience in payer relations or contract management required.
• Strong attention to detail and data integrity.
• Excellent written and verbal communication with confidentiality.

Aufgaben

• Negotiates and manages individual patient Single Case Agreements (SCAs) and payer contract activities for contracted and non-contracted payors.
• Assists with the identification and coordination of non-contracted patient cases requiring SCA review and operational follow-up.
• Coordinates the implementation, execution, maintenance, and compliance of SCAs and payer contract documentation.
• Develops and maintains collaborative relationships with payer representatives and internal stakeholders.
• Provides operational guidance and serves as a resource regarding managed care, reimbursement, and SCA workflows.
• Develops and delivers education, training, and resource materials related to SCAs, payer operations, and managed care processes.
• Monitors payer contract and SCA performance, reimbursement activity, operational effectiveness, and regulatory developments.
• Supports process improvement and operational implementation initiatives related to payer relations and managed care activities.
• Prepares reports, analyses, and summaries related to SCA activity and payer relations.
• Acts as operational resource to departments regarding payer and reimbursement issues.

Ausbildung

Bachelor's Degree in business administration or healthcare administration, or a related field

Jobbeschreibung

Johns Hopkins Health System in Baltimore is seeking a Finance professional to oversee Single Case Agreements (SCAs) and payer contract activities for contracted and non-contracted payors. You will coordinate SCA reviews, implement contracts, and guide internal staff on managed care workflows.

With a background in healthcare administration and payer relations, you will build relationships with payers and internal stakeholders, deliver education on SCA processes, and monitor contract performance