Specialist, Payer Relations

Welcome to Ovation Healthcare! At Ovation Healthcare (formerly QHR Health), we’ve been making local healthcare better for more than 40 years. Our mission is to strengthen independent community healthcare. We provide independent hospitals and health systems with the support, guidance and tech-enabled shared services needed to remain strong and viable. With a strong sense of purpose and commitment to operating excellence, we help rural healthcare providers fulfill their missions. The Ovation Healthcare difference is the extraordinary combination of operations experience and consulting guidance that fulfills our mission of creating a sustainable future for healthcare organizations. Ovation Healthcare’s vision is to be a dynamic, integrated professional services company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer focused behavior. We’re looking for talented, motivated professionals with a desire to help independent hospitals thrive. Working with Ovation Healthcare, you will have the opportunity to collaborate with highly skilled subject matter specialists and operations executives, in a collegial atmosphere of professionalism and teamwork. Ovation Healthcare’s corporate headquarters is located in Brentwood, TN. For more information, visit www.ovationhc.com. Summary: The Payer Relations Specialist is responsible for supporting clients throughout the enrollment lifecycle and advising on billing structure and setup to ensure alignment with contractual and compliance requirements. This role is responsible for enrolling healthcare providers with commercial and government payers, ensuring timely credentialing and participation in insurance networks to ensure timely and accurate credentialing and participation in payer networks. Duties and Responsibilities: • Coordinate Kick off and follow up meetings with the hospital. • Collect and validate data collection from hospital. • Collect payor agreements and ensure all needed information is included • Assist with data analysis and create tables and forms for Presentation. • Assist with presentation draft and conduct validation call with hospital. • Model Portal – Maintain all request for all hospital models and maintain tracker • Graphically/analytically strong • Monitor and manage assigned deadlines for models. • Manage review calls • Manage data validation for all MCA hospitals. Checking for excessive 0 payments, 0 dollar contracted rates, ensure contract updates are implemented including rate escalators. • Assist with managing new implementations. Manage implementation tracker and communication weekly to facility Additional responsibilities: • Assist in data collections for contract modeling and assessments. • Assist with Adhoc reporting requests • Assist with validating financial analysis prior to presenting to hospital or payers. • Develops and grows positive, long-term relationships with clients to support and improve financial and quality performance. • Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems. • Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations. • Identify ways to enhance performance management and operational reports related to new business implementation processes. • Develop, share, and incorporate organizational best practices into business applications. QUALIFICATIONS: • Minimal travel • Understanding of managed care contracting and related initiatives are useful but not required as well as the underlying systems that support those initiatives. • Understanding of Revenue Cycle process useful but not required. • BS Preferred • Multitasking • Advanced knowledge of Microsoft products Excel, PowerPoint, PowerBI etc. • Strong communication skills • Ability to interact with clients • Team player • Organizational skills • Data analysis experience critical • Critical thinker • Problem solving skills • Ability to work in a fast pace environment independently Apply tot his job Apply To this Job