Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 45 hospitals and has more than 300 outpatient locations in 14 states providing more than 2.6 million patient visits annually. It is one of the nation’s leading health systems with nearly 50,000 employees and physicians. Fourteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

This position will ensure compliance with corporate policies regarding payment and contractual allowance verification with all payers by managing the software systems that contains all payer contracts and calculations of expected reimbursement. This position will provide decision support to management as needed for new and or changing reimbursement rates. This position will review contract terminology and concepts and analyze data to ensure contract performance. Coordinates and monitors contract performance and compliance. Supports strategies for maximizing contract reimbursement and value. Identifies and interprets trends and patterns within contracting to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge.

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EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

1. Bachelor’s Degree in the healthcare field or at least 5 years of previous experience in a healthcare organization with a focus on contracting and financial analysis
2. 2 years’ experience with validating and loading contracts
3. Excellent oral and written communication and interpersonal skills
4. Excellent analytical skills required
5. Experience with database and data analysis technology
6. Experience evaluating potential new products, services, and programs in the Medicare, Medicaid, and commercial value-based care environment
7. Experience with contract modeling and contract loading

Preferred qualifications:

1. Knowledge of provider contracting, financial arrangements, and fee schedules, including understanding of healthcare reimbursement methodologies and guidelines preferred

Prime Healthcare Management Inc. offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options.  Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary.  A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $81,432.00 to $109,928.00 on an annualized basis. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. EEO is the Law: https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf