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Contract Coordinator

Company: Destiny Home Health & Hospice
Location: Moreno Valley
Posted on: June 6, 2021

Job Description:

Job Description Destiny Home Health is looking for a qualified Contract Coordinator who is dedicated to their craft and is driven by excellent patient care. Are you interested in taking your skills to a new level? Would you like to work in an environment that cares about you and is interested in cultivating your talents and strengths? Destiny could be the employer youre looking for. Destiny prides itself in allowing its employees to increase their skills by progressive styles in training and development. Are you tired of feeling like just another employee? Destinys culture shows concern for its patients and its employees, by providing a family environment that helps our employees grow individually and professionally. Territory......Moreno Valley We offer; Competitive pay Excellent Benefits Medical, Dental, Vision, Sick, & Vacation Holiday Pay Additional Benefits; Comprehensive Training Flexible Schedule JOB DESCRIPTION SUMMARY The Contract Manager is responsible for coordinating all organizations contracts for Home Health, Hospice & Palliative and the Congregate Living Health Facility (CLHF), to ensure the growth and sustainability of the Agencies. ESSENTIAL JOB FUNCTION/ RESPOSIBILITES Review of on-going inquires for health plan contracts for all service line of businesses, Prompt negotiation and renegotiation of rates to meet the clinical and clerical staff services, and patients care provided to sustain the operation of the organizations. Work closely with our managers, billing, intake and scheduling team to ensure seamless service provision from referral, LOA, pre-authorization to admission, and patients discharge from services. 1. Prompt contact to the payer source for potential Level of Agreement for non contracted health plan. Assist the team listed above with issues related to patients insurance obtaining pre-authorization, deductible, and share of cost due from patients before care is initiated and assist to resolve all insurance related issues.

2. Approach insurance companies and health plans responsible for payment when there are changes on patients coverage or terminations of coverage.

3. Coordinates with all health plans changes in our patients coverage for home health, hospice & palliative care and CLHF services. 4. Promptly distributes copies of updated health plans contract to the billers, intake and referrals coordinator for all Destiny lines of service. 5. Coordinates and distributes authorization reports and additional information to intake and scheduling team to ensure appropriate co-pays and deductions before assignment of staff to patients care. 6. Has a clear understanding of the complexity of managed care / health plans and reimbursement methodologies and JACHO standards. 7. Drafts proposals and negotiate contractual assets with CEO & CFO upon addition of new Health Plans for service contracts. 8. Understands the negotiations of carve outs for health care policies, fee schedules, supply cost and episodic case rates or bundle payments. 9. Maintains proper records, files and receipts for all insurance and health plan contracts and coverage areas. 10. Correlates information needed for the community liaisons and educators with the health plans, inpatients and outpatients case managers and discharge planers in effort to utilize the contract for patients referrals. 11. Monitor contractual compliance, identify operational issues, and assist with solutions to resolve billing or other performance problems.

12. Assist with orientation of new sales employees on organizations health plans and Skill Nursing Facilities contracted related to Home Health, Hospice and Palliative Services.

13. Notify the Regional Executive Director, managers, sales and Intake team immediately upon contract termination and failure to renegotiate contract to an affordable rate for financial sustainability that may result in the delay of patients care. 14. Maintains current records health plans contracted with Destiny Home Health, Hospice, Palliative Care and CLHF. 15. Performs annual contract review, negotiation and renegotiation of new and updated rates, and present report to the CEO/CFO or the designee. 16. Performs other necessary functions as assigned by the Director of Nursing and Clinical Supervisor.

POSITIONS QUALIFICATIONS 1. Minimum of Bachelors degree in related field 2. General knowledge of typing, Excel, Micro Soft office 3. Previous or extensive knowledge of health plans, insurance, and contract negotiations. 4. Ability to establish and maintain effective working relationships with Health Plans and Payers 5. Effective social interaction, communication and organization skills. Ability to perform a variety of related and unrelated task efficiently. 6. Personal and reliable transportation for travel to and from work 7. Must maintain a valid drivers license 8. Must carry and maintain auto liability insurance coverage.

The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job related tasks other than those stated in this description. Company Description The Destiny Hospice and Home Health team is comprised of physicians and our caring and compassionate staff members who provide support to patients and loved ones around the clock, 24 hours a day, 7 days a week. Our hospice team includes a Medical Director who will consult with your physician to manage pain, symptoms, and make house calls as needed. Our nurses will assess and manage your pain and provide overall care. Home health aides help with personal care and lighten the burden of caregivers by helping with light household chores. Our Social workers counsel and provide emotional support and help with financial planning and other life issues. Our Chaplains offer pastoral care, by addressing the spiritual concerns of patients and loved ones. Our volunteers are specially trained and are available to offer companionship, emotional support, and assist our patients and their families when theyre needed. Bereavement Support for loved ones continues for 12 months or longer after the patient has passed on.

Keywords: Destiny Home Health & Hospice, Moreno Valley , Contract Coordinator, Other , Moreno Valley, California

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