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Payor Accounts Program Consultant

Company: Banner Health
Location: Phoenix
Posted on: March 20, 2023

Job Description:

Payor Accounts Program Consultant page is loaded Payor Accounts Program Consultant Apply locations Banner Health Corp Phoenix (2901 N Central Ave) time type Full time posted on Posted Yesterday job requisition id R105385 Primary City/State:Phoenix, ArizonaDepartment Name:Medicare FFS ACOWork Shift:DayJob Category:General OperationsGreat careers are built at Banner Health. We understand that talented professionals appreciate having options. We are proud to offer our team members many career and lifestyle choices including remote work options. Apply today, this could be the perfect opportunity for you.As a Payor Accounts Program Consultant, you will manage programs that have financial impact for Medicare and Medicaid patients. This role requires regulation reading, interpretation, and implementation of action plans to support financial performance. There is a combination of cross-functional meetings that are lead with C-suite leaders and peers along with routinized work. Experience in healthcare, insurance processes, or an understanding of project/program management will be beneficial in this position. Hours for this remote position are 7AM-5PM Monday-Friday.Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.POSITION SUMMARY
This position is responsible for assisting with ensuring operational support for all programmatic functions for Medicaid and Medicare Programs that will drive superior product performance. The position will provide ongoing support to ensure compliance and operational performance of new and existing programs and projects. This position works both independently and collaboratively with all health plan, network, or organizational functional areas with the purpose to support the development, implementation, maintenance, monitoring, and continuous improvement of Medicaid and Medicare Programs. The Government Programs Senior Manager will work closely with the Health Plan, Network, or Other Entity Leadership to create a metric driven and results oriented reporting environment to manage the strategic and tactical side of the business. This position will have responsibility for supervising a support staff.

1. Ensures all Medicare and Medicaid regulatory and policy guidance are disseminated and implemented in a timely manner with the business owners and partners to ensure that such guidance is strictly adhered to, implemented and monitored and that evidence of implementation is verified and documented.
2. Manages and oversees the product development strategic plan which includes developing the initiatives with each matrix area and setting up follow up meeting and tracking documents to ensure we are achieving towards the agreed upon goals. 3. Manages, tracks, and oversees compliance with contract deliverable requirements. Assists all functional areas with ensuring they are aware of the most current deliverables are on track and assist the functional areas with any challenges or items at risk by raising those concerns to executive leadership 4. Attends Medicare and Medicaid regulatory calls and meetings and disseminates and trains on appropriate material from the calls/meetings.

5. Assists with researching and tracking the Medicaid and Medicare regulatory environment and initiatives in collaboration with Health Plan, Network, or Entity Administrators, Senior Leaders, - and Compliance Departments. Ensures the regulatory reporting requirements, training and oversight for the Medicare and Medicaid LOBs are timely, accurate and compliant.

6. Collaborates with other Health Plan Departments to ensure effective partnerships are developed and maintained. Maintains knowledge and communicates trends within our markets and the industry overall.


Must possess knowledge as normally obtained through the completion of a bachelor's degree in health care administration, finance administration or organizational/project management.

Three or more years of Medicare Advantage equivalent combination of operational work experience. The work requires a high degree of organization, the ability to manage time and resources effectively, and the self-starter ability to work independently to achieve goals. Effective customer service and interpersonal relations skills are necessary. The ability to communicate effectively verbally, in writing and through common computer software is required.

Excellent Microsoft Office Suite Skills including Visio with a focus on developing dashboards and presentations. Excellent Power Point and Excel skills needed and MicroSoft Project.


Additional related education and/or experience preferred. EOE/Female/Minority/Disability/Veterans Our organization supports a drug-free work environment. Privacy Policy About Us Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee. COVID-19 Vaccine Requirements The safety of our team members and patients is of utmost importance, so Banner is requiring the COVID-19 vaccine for all team members, with a deadline to become fully vaccinated by Nov. 1, 2021. As members of the health care field, we are in the business of caring for people, so we take seriously our commitment to ensure our patients and teams are safeguarded from this rapidly changing and dangerous disease. Total Rewards We are proud to offer a comprehensive benefit package for all benefit-eligible positions. Please visit our Benefits Guide for more information. EOE/Female/Minority/Disability/Veterans Banner Health supports a drug-free work environment. Privacy Policy

Keywords: Banner Health, Phoenix , Payor Accounts Program Consultant, Professions , Phoenix, Arizona

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