Program Manager - Transplant Pricing

Program Manager - Transplant Pricing - Southwestern Health Resources

Southwestern Health Resources is looking for a highly skilled Program Manager - Transplant Pricing . Is that you?

Work Location: Southwestern Health Resources Headquarters, Hybrid: 1601 Lyndon B. Johnson Freeway, Farmers Branch, TX 75234.

Work Hours: Full Time Days (8: 00am-5: 00pm) for 40 hrs/week (remote work allowed at manager's discretion)

Department Highlights:

• Hybrid Position
• Gain a sense of accomplishment by contributing to a teamwork environment.
• Receive excellent mentorship, comprehensive training, and dedicated leadership resources.

What You Will Do:

Manage and lead the pricing and modeling of analytics for all transplant contracts. Driving alignment among stakeholders regarding reimbursement methodologies, contract strategy, operational workflows, and program objectives. 65%
Lead evaluation and implementation of reimbursement strategies related to emerging transplant technologies, regulatory changes, and evolving payment models. Serve as the subject matter expert for industry trends and best practices as it relates to transplant programs and models. 15%
Lead cross-functional initiatives involving contracting, finance, revenue cycle, operations, clinical leadership, and external stakeholders to ensure successful program execution. Including performance monitoring to ensure barriers are being addressed, and actioanble insights are being surfaced to achieve the organizations goals. 10%
Manage relationships with payers, providers, consultants, and strategic partners related to transplant reimbursement arrangements and bundled payment methodologies. 10%

What You Need:

Education
Bachelor's Degree Business related field Req

Experience
4 Years Decision support or financial analysis to include SQL or relational database experience and/or reimbursement methodologies. Req and
2 Years Transplant Bundle Reimbursement Knowledge Req

Skills
Strong math and computer aptitudes are needed in order to understand and model complex structures and relationships.
Effective communication and presentation skills.
Must be highly knowledgeable of hospital coding systems and a strong understanding of healthcare reimbursement concepts, including ICD-10 diagnosis and procedure coding, MS-DRGs, HCPCS/CPT coding, cost accounting, and Medicare cost reporting principles related to organ acquisition.

Supervision
Individual Contributor

ADA Requirements
Working Indoors 67% or more

Physical Demands
Sedentary