Skip to main content
Finance@2X
J178209

Manager, Managed Care Support

Allegheny Health Network

  • Company AHN
  • Pittsburgh, PA - Allegheny Clinic
  • Finance
  • Full time
  • Day (United States of America)

Company :

Allegheny Health Network

Job Description : 

General Overview:

Responsible for maintenance of facility contracts in EPIC contract management system ensuring accurate adjudication of AR for Revenue Cycle as well as accurate payments from payors. Responsible for hospital contract analysis including contract modeling and monitoring of contract performance. Additionally, this role will provide accurate and timely hospital reimbursement and payor policy information to various departments across Allegheny Health Network.

Essential Job Functions:

  • Manage contract loading and refreshing of contract terms in contract management system. Ensure accuracy of contracts in the system. Oversight and responsibility for knowing effective dates of contract changes, updates and implementation dates.

  • Manage underpayment work queues and manage team responsible for working the queues.

  • Perform analysis of underpayment or denial trends to determine root cause and opportunities for work flow or contract changes.

  • Provide supervision and guidance to direct reports. Review performance standards and establish goals and objectives for the departments. Coaching and mentoring managed care and follow up teams.

  • Manage underpayment vendor logs and access to AHN systems.

Minimum Qualifications:

  • Bachelor's degree in Finance, Business, or Healthcare Administration

  • 5-7 years experience in health care: provider or insurance

  • 1-3 years management experience

Preferred Qualifications:

  • Expertise with various government hospital reimbursement methodologies. 

  • Previous experience with hospital reimbursement analytics

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice


Thumbnail Join Talent Community@2X

Connect with a career that’s right for you.

Introduce yourself and we'll get in touch monthly to share career insights and company news.

Join Our Talent Community