HCA Holdings, Inc
Job Code: 08910-150754
Work From Home
GENERAL SUMMARY OF DUTIES - The Concuity Contract Modeler is responsible for supporting the Shared Service Center based modelers by translating and modeling standard Government, National managed care contracts and Global templates in Clear Contracts.
DUTIES INCLUDE BUT ARE NOT LIMITED TO:
* Model managed care contract payment terms using ClearContracts
* Review, create and maintain ClearContracts master files including global service descriptions, service rules, global fee schedules, profiles and hierarchy profiles
* Complete appropriate Sarbanes Oxley workflow steps within the Calc Engine of ClearContracts
* Complete testing of contract models by service line and keep documentation of accuracy in the Documentation & Compliance Module of ClearContracts
* Upload and attach all pertinent contract documentation related to the rate schedules within the Documentation and Compliance Module of ClearContracts
* Complete and maintain the Legal Options section on the Documentation & Compliance tab
* Coordinate with IT&S Reimbursement Product Support for the modeling of Government or other contracts modeled directly in the Payment Calculator System for contract effective periods prior to ClearContracts implementation
* Provide the Shared Service Center Modelers with support for model updates using existing tools during the ClearContracts transition period
* Provide educational resources to support contract implementation and administration
* Liaison with Managed Care Services Group and Payors to address managed care contract administration issues related to Governmental, National or Global Models
* Coordinate managed care contract implementation activities with the Managed Care VP s, Managed Care Services Group and the functional managers within the Shared Services Center
* Practice and adhere to the Code of Conduct philosophy and Mission and Value Statement
* Other duties as assigned
KNOWLEDGE, SKILLS & ABILITIES
* Communication - communicates clearly and concisely, verbally and in writing
* Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
* Interpersonal skills - able to work effectively with other employees and external parties
* PC skills - demonstrates proficiency in Microsoft Office applications and others as required
* Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems
* Basic skills - able to perform moderately complex mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately
* Excellent oral and written communication skills
* Self motivated
* Able to work independently and as a team member
* Detail oriented
* Excellent PC skills including experience with Microsoft Office and Excel
* Excellent people skills
* Management skills
* Organizational skills
* Undergraduate degree required
* Minimum 3years HCA experience preferred
* Proven ability to manage project work
* Required understanding of medical finance, managed care contracting, or business office/claims shop operations
* Working knowledge of managed care contracting and modeling preferred
Last Edited: 06/12/2018
Diversity is valued and actively promoted in the workforce at all levels. We strive to celebrate cultural and other differences and consider them strengths of the organization.
We are committed to:
Providing an inclusive work environment where everyone is treated with fairness, dignity and respect.
Recruiting and retaining a diverse staff reflective of the patients and communities we serve.
Equal employment opportunities are provided to all employees and applicants for employment without regard to race, color, religion, gender, national origin, citizenship, age, disability, sexual orientation, genetic information, gender identity, protected veteran status, or any other legally protected category in accordance to applicable federal, state, or local laws.
The policy applies to all terms and conditions of employment including, but not limited to, hiring, placement, promotion, termination, layoff, transfer, leaves or absence, compensation and training.
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At its founding in 1968, Nashville-based HCA was one of the nation's first hospital companies. Today, we are the nation's leading provider of healthcare services, a company comprised of locally managed facilities that includes about 165 hospitals and 115 freestanding surgery centers in 20 states and England and employing approximately 204,000 people. Approximately four to five percent of all inpatient care delivered in the country today is provided by HCA facilities. Milton Johnson serves as Chairman and Chief Executive Officer of HCA. HCA is committed to the care and improvement of human life and strives to deliver high quality, cost effective healthcare in the communities we serve. Building on the foundation provided by our Mission & Values, HCA puts patients first and works to constantly improve the care we give them by implementing measures that support our caregivers, help ensure patient safety and provide the highest possible quality. Investing in our communities is important to us. HCA typically invests about $1.5 billion annually to keep our facilities modern and up-to-date technologically and to expand and add services where needed. Focusing primarily on communities where the company is a leading healthcare provider, HCA selectively adds new facilities in order to better serve our communities. And because two HCA founders were physicians, we value highly the strong relationships we've created with local physicians. We endeavor to provide them with a wide array of services and modern facilities in order to help them deliver the best possible care.