Remote Payer Relations & SCA Admin

Johns Hopkins Medicine; Baltimore (MD); Remote; USD 43,000 - 72,000; Full time

Benefits offered by this job

Career growth

Diverse collaboration

Paid time off

Tuition reimbursement

Comprehensive benefits

Job summary

Johns Hopkins Medicine is seeking a detail-oriented administrator to oversee Single Case Agreements (SCAs) and payer contract activities, ensuring compliance across contracted and non-contracted payors. You will serve as a resource to staff and leadership, guiding managed care operations and reimbursement strategies.

The role emphasizes collaboration with payer representatives and internal teams, delivering training and materials on SCA workflows while monitoring performance and regulatory

Qualifications

• Bachelor's Degree in business administration or healthcare administration, or a related field (Required)
• One year of relevant education may be substituted for one year of required work experience or one year of relevant professional-level work experience may be substituted for one year of required education.
• Experience in payer relations or contract management (Required)
• Navigate rapidly changing situations, from evolving patient needs to technological advancements, by remaining flexible, continuously learning, embracing new challenges, and quickly recovering from setbacks.
• Good written and verbal communication skills with an emphasis on confidentiality, tact, and diplomacy.
• Strong attention to detail and self-directed to consistently ensure data integrity and accuracy.

Responsibilities

• Negotiates and manages 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.

Skills

Payer relations

Contract management

Communication skills

Data accuracy

Education

Bachelor's Degree in business administration or healthcare administration

Job description

Johns Hopkins Medicine is seeking a detail-oriented administrator to oversee Single Case Agreements (SCAs) and payer contract activities, ensuring compliance across contracted and non-contracted payors. You will serve as a resource to staff and leadership, guiding managed care operations and reimbursement strategies.

The role emphasizes collaboration with payer representatives and internal teams, delivering training and materials on SCA workflows while monitoring performance and regulatory