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Net Revenue Manager

External
christianacare logoChristianacare · Wilmington, DE
ContractOn-site2d ago
ComplianceCross-functional CollaborationEpicNegotiation
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Benefits

Health insuranceDental insuranceVision insuranceParental leave

Additional Information

Job Details Are you looking to work for a company that is based on excellence and love? Then this is the position you need to check out! ChristianaCare is one of the country's most dynamic healthcare organizations, centered on improving health outcomes, making high-quality care more accessible, and lowering healthcare costs. ChristianaCare includes an extensive network of outpatient services, home health care, urgent care centers, three hospitals (1,299 beds), a free-standing emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care, and women's health. It also includes the pioneering Gene Editing Institute and was rated by IDG Computerworld as one of the nation's Best Places to Work in IT. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. It is continually ranked by U.S. News & World Report as the Best Hospital. With the unique CareVio data-powered care coordination service and a focus on population health and value-based care, ChristianaCare is shaping the future of health care. ChristianaCare Offers Full Medical, Dental, Vision, Life Insurance, etc. Two retirement planning offerings, including 403(b) with company contributions Generous paid time off with annual roll-over and opportunities to cash out 12-week paid parental leave Incredible Work/Life benefits including annual membership to care.com, access to backup care services for dependents through Care@Work, retirement planning services, financial coaching, fitness and wellness reimbursement, and great discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets and much more! About This Position ChristianaCare is searching for a Net Revenue Manager to play a critical role in advancing Epic payer contract modeling, which will support the organization in financial decisions related to payer contract negotiations and impact of imposed payer policies. This role will have responsibilities for the review and analysis of data related to projects where net revenue neutrality needs to be maintained. Additionally, this position oversees Epic payer plan committee, payer plan maintenance and transactional mapping for Epic-to-Workday financial interfaces. PRINCIPAL DUTIES AND RESPONSIBILITIES: Payer Contract Modeling, Reporting and Analytics: Develop and maintain contract models using Epic's contract modeling tool, analyze impact of DRG updates, payer policies, and repricing activities. Evaluate contract proposals and support payer negotiation strategies through modeling and monetary impact analysis. Design and produce contract variance reports, net-to-gross analyses, and other analytics to support Finance, Revenue Cycle and Managed Care teams. Identify and analyze overpayment/underpayment patterns, escalating systemic payer issues as needed. Maintain client billing contracts and conduct periodic rate reviews; track and follow up on required updates with stakeholders. Net Revenue Neutrality: Support net revenue neutrality projects, including review of vendor work related to pricing and charging methodology changes. Assist in annual CDM pricing updates, working with Revenue Integrity, price transparency vendor, and finance to provide for timely and accurate gross revenue budgets by department. Coordinate periodic charge reviews - especially for physician billing - to prevent revenue leakage and ensure compliance with payer contract "lesser of" rules. Payer Plan Administration: Lead Payer Plan Committee meetings and ensure alignment across hospital and professional billing, payer reimbursement, and managed care teams. Maintain Epic payer plan insurance table, including setup, change control, mapping, and inactivation of plan codes. Maintain accuracy and consistency for payer plan and all transactional mapping for Epic-to-Workday financial interfaces. Cross-Functional Collaboration: Communicate and collaborate regularly with managers, IT, Finance and Revenue Cycle teams to share updates and resolve outstanding issues. Assist as needed in updating and maintaining contracts within Experian's Price Estimator tool, including testing system for accuracy of patient estimates. EDUCATION AND EXPERIENCE REQUIREMENTS: Bachelor's degree - Accounting or Finance Five to seven years of experience in healthcare finance preferred. Knowledge of healthcare reimbursement, patient accounting and contract management preferred, as well as confidence in working with substantial amounts of data. Contract management systems and/or Epic experience required Annual Compensation Range $79,497.60 - $127,212.80 This pay rate/range represents ChristianaCare's good faith and reasonable estimate of compensation at the time of posting. The actual salary within this range offered to a successful candidate will depend on individual factors including without


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