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Veterans at Abbott

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Abbott National Contracting Leader in Gainesville, Florida

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 107,000 colleagues serve people in more than 160 countries

EPHF Leading an active lifestyle is important to the many people we serve. In Abbott’s Heart Failure division, we’re advancing the treatment of heart and vascular disease through breakthrough medical technologies in electrophysiology and heart failure, allowing people to restore their health and get on with their lives.

WHAT YOU’LL DO

The National Payor Contract Leader is responsible for leading the negotiation and management of patient specific Letters of Agreements (LOA) for Mechanical Circulatory Support (MCS), Neuromodulation (NMD), and new product lines for Continuum Services. This position will prepare pricing for LOAs with payors, review language and negotiate the letters of agreements. Provide education on best practices to Continuum customer service and billing team members.

  • Prepare proposals for pricing for patient specific letters of agreement.

  • Lead the negotiation and management for patient specific letters of agreements with health care payors for MCS, NMD product lines, and new product lines.

  • Review language in letters of agreement, redline with alternative language with recommendations to legal team.

  • Negotiate LOAs with health care payors for MCS and NMD product lines from the beginning of negotiation of rates and language through execution and implementation.

  • Ensure compliance with company’s contracting policies, procedures and the smooth operation/administration of letters of agreements.

  • Identify LOA payors to broaden payor network access for Continuum business.

  • Liaison with the customer service and billing team to ensure LOA loading accuracy and claims accuracy.

  • The scope of the LOA includes national health insurance companies, national payor networks, managed care organizations, hospital health systems, medical groups, IPAs, third party administrators (TPA), reinsurance companies, and workers compensation payors/networks.

  • Manage record keeping of LOAs on the shared drive.

  • Communicates regularly with billing to review payor payment trends. Facilitate meetings with payors as needed to improve collections.

  • Responsible for preparation of reports and special projects.

  • May provide guidance or expertise to less experienced specialists.

  • Works closely with the National Payor Contracting Manager and Senior Manager of Operations.

  • Adheres to Abbott guidelines including safeguarding all proprietary and confidential information.

  • Assists Continuum team members on issues, concerns, and strategies regarding the Continuum business.

  • Attends conferences and conventions as needed.

  • Ability to communicate with payor medical director, hospital administration, medical directors, case managers, nurses, doctors and corporate legal counsel.

  • Educates and inform Continuum team members on payer LOA requirements.

  • Communicates regularly with Customer Service and Billing Supervisors regarding best practices.

  • Performs other duties and responsibilities as required or requested, including travel when necessary.

EDUCATION AND EXPERIENCE YOU’LL BRING

Required

  • A Bachelor’s degree or equivalent is required, masters or other advanced schooling preferred, and 5 years of relevant working experience in provider/payor contracting in a managed care or hospital setting.

  • Extensive knowledge of health insurance plans (Medicare, Medicaid, Managed Care, PPO, POS, Self-funded, TPAs, Workers Comp, etc.) and health care environment.

  • Working knowledge of HCPCS and ICD-10 codes.

  • Working method can be characterized as taking on responsibility with independence or autonomy.

  • Works well with management, peers and subordinates.

  • Computer literacy required, specifically with MS Word (including track changes to redline contracts), Excel and business systems.

  • Excellent written and verbal communication skills.

  • Advanced knowledge of provider contracts and health care reimbursement and ability to negotiate effectively with internal/external stakeholders and payers. Payors includes national payors, national networks, managed care organizations (HMO, PPO, POS, EPO), providers at financial risk (hospital/health system, medical group and IPA), Self-funded plans, Third Party Administrators, and Workers Compensation payors/networks.

  • Must have skill in negotiating contracts and agreements.

WHAT WE OFFER

At Abbott, you can have a good job that can grow into a great career. We offer:

  • Training and career development , with onboarding programs for new employees and tuition assistance

  • Financial security through competitive compensation, incentives and retirement plans

  • Health care and well-being programs including medical, dental, vision, wellness and occupational health programs

  • Paid time off

  • 401(k) retirement savings with a generous company match

  • The stability of a company with a record of strong financial performance and history of being actively involved in local communities

*Learn more about our benefits that add real value to your life to help you live fully: * www.abbottbenefits.com at http://www.abbottbenefits.com/pages/candidate.aspx

Follow your career aspirations to Abbott for diverse opportunities with a company that provides the growth and strength to build your future. Abbott is an Equal Opportunity Employer, committed to employee diversity.

Connect with us at www.abbott.com at http://www.abbott.com/ , on Facebook at www.facebook.com/Abbott and on Twitter @AbbottNews and @AbbottGlobal.

An Equal Opportunity Employer

Abbot welcomes and encourages diversity in our workforce.

We provide reasonable accommodation to qualified individuals with disabilities.

To request accommodation, please call 224-667-4913 or email corpjat@abbott.com

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