Program Manager - Transplant Pricing

Southwestern Health Resources; Dallas (TX); Hybrid; USD 110,000 - 140,000; Full time

Job summary

Southwestern Health Resources is seeking a Program Manager - Transplant Pricing to lead pricing analytics for all transplant contracts, drive alignment among stakeholders on reimbursement methodologies, contract strategy, and program objectives in a hybrid work setting.

The role focuses on evaluating reimbursement strategies for emerging transplant technologies, coordinating cross-functional initiatives with contracting, finance and operations, and managing relationships with payers and

Qualifications

• 4 years of decision support or financial analysis experience including SQL or relational databases.
• 2 years of transplant bundle reimbursement knowledge.
• Strong math and computer aptitude to model complex structures.

Responsibilities

• Lead pricing and modeling analytics for all transplant contracts.
• Drive alignment among stakeholders on reimbursement methodologies, contract strategy, workflows and program objectives.
• Evaluate reimbursement strategies for emerging transplant technologies and regulatory changes.
• Collaborate across contracting, finance, revenue cycle, operations and clinical leadership to execute the program.
• Manage relationships with payers, providers, consultants and strategic partners on transplant reimbursement arrangements.

Skills

Decision support

SQL

Data modeling

Communication

Pricing reimbursement

Education

Bachelor's degree in Business

Tools

Relational databases

Excel

Job description

Program Manager - Transplant Pricing - Southwestern Health Resources

Southwestern Health Resources is looking for a highly skilled Program Manager - Transplant Pricing . Is that you?

Work Hours:Full Time Days (8:00am-5:00pm) for 40 hrs/week (remote work allowed at manager's discretion)

Department Highlights:

• Hybrid Position
• Gain a sense of accomplishment by contributing to a teamwork environment.
• Receive excellent mentorship, comprehensive training, and dedicated leadership resources.

What You Will Do:

Manage and lead the pricing and modeling of analytics for all transplant contracts. Driving alignment among stakeholders regarding reimbursement methodologies, contract strategy, operational workflows, and program objectives. 65%
Lead evaluation and implementation of reimbursement strategies related to emerging transplant technologies, regulatory changes, and evolving payment models. Serve as the subject matter expert for industry trends and best practices as it relates to transplant programs and models. 15%
Lead cross-functional initiatives involving contracting, finance, revenue cycle, operations, clinical leadership, and external stakeholders to ensure successful program execution. Including performance monitoring to ensure barriers are being addressed, and actioanble insights are being surfaced to achieve the organizations goals. 10%
Manage relationships with payers, providers, consultants, and strategic partners related to transplant reimbursement arrangements and bundled payment methodologies. 10%

What You Need:

Education
Bachelor's Degree Business related field Req
Experience
4 Years Decision support or financial analysis to include SQL or relational database experience and/or reimbursement methodologies. Req and
2 Years Transplant Bundle Reimbursement Knowledge Req
Skills
Strong math and computer aptitudes are needed in order to understand and model complex structures and relationships.
Effective communication and presentation skills.
Must be highly knowledgeable of hospital coding systems and a strong understanding of healthcare reimbursement concepts, including ICD-10 diagnosis and procedure coding, MS-DRGs, HCPCS/CPT coding, cost accounting, and Medicare cost reporting principles related to organ acquisition.
Supervision
Individual Contributor
ADA Requirements
Working Indoors 67% or more
Physical Demands
Sedentary

Additional Information

• Job Field: Clerical/Admin
• Shift: Day Job
• Schedule: Full-time