Carolinas Healthcare System (Now Atrium Health) Work Values

Daily Duties at Carolinas Healthcare System (Now Atrium Health):

• Created, negotiated, and maintained Excel models, contract language, and reimbursement rates pertaining to multimillion-dollar payer agreements and solid organ transplant contracts with major health insurance carriers and third party payers. Developed, negotiated, structured, and managed multimillion-dollar transplant network contracts (singular and full network coverage). Resolved managed care contract issues, includingfinancials and patient care. Served as liaison between managed care plans and internal departments. Composed and distributed internal communications detailing priority information regarding managed care plan products, policies, and contractual changes. Monitored, reviewed, and reported financial and operational performance of assigned multimillion-dollar payer contracts to Executive Board. Manipulated databases from multiple systems using MS Office. Utilized CPT4 coding, current ICDs, DRGs, and current Medicare reimbursement methodologies. Assisted Underpayment Recovery department with denials and appeals on underpaid claims. Advised Medicare and Medicaid members of facility and provider network status. Constructed contracts based on lump sum payment, provider incentive, and risk methodology. Deteremined contract continuance or termination based upon market demographics, client base, community needs, and brand recognition. • Drove transplant program growth by winning contracts with two of the largest national healthcare insurance companies. • Devised Excel models to automate and streamline rate calculation and data interpretation. • Co-developed internal database design providing pertinent contract language and insurance carrier information in a more organized and accessible format.

What they like about Carolinas Healthcare System (Now Atrium Health):

You give high priority to hiring firms with prestige. Market reputation and prestige of a firm may be determined through on-line research, and conversations with individuals working in your target industry. Note that firms "in the public eye" receive a great deal more critical publicity and attention than those operating with more anonymity. So as you assess your employment opportunities, be sure to seek out the positive aspects of the firm's reputation in addition to noting negative publicity the company may have received.

Tags

Health Insurance, Insurance, Managed Care, Medicare, Microsoft Office, Human Resources, Legal, Contract Management, Contract Negotiations, Editing, Writing, Amendments, Leadership, Engagement, Management

Skills

Team Leadership, Engagement , Microsoft Office, Business Administration, Recruitment, Human Resources, Office Management, Contract , Contract Administration, Editing, Writing, Organization, Process Management

These are some of the questions we asked our climbers about their experiences with Carolinas Healthcare System (Now Atrium Health):