Government Payer Program Manager

You.

You bring your body, mind, heart and spirit to your work as a Government Programs Program Manager.

You’re great at what you do, but you want to be part of something even greater. Because you believe that while individuals can be strong, the right team is invincible.

Us.

System Services is our Corporate Headquarters in Broomfield, Colorado and is located within the Oracle campus. SCL Health is a faith-based, nonprofit healthcare organization dedicated to improving the well-being of the people we serve.

Benefits are one of the ways we encourage health for you and your family. Our generous package includes medical, dental and vision coverage. But health is more than a well-working body: it encompasses body, mind and social well-being. To that end, we’ve launched a Healthy Living program to address your holistic health. Healthy Living includes financial incentives, digital tools, tobacco cessation, classes, counseling and paid time off. We also offer financial wellness tools and retirement planning.

We.

Together we’ll align mission and careers, values and workplace. We’ll encourage joy and take pride in our integrity.

We’ll laugh at each other’s jokes (even the bad ones). We’ll hello and high five. We’ll celebrate milestones and acknowledge the value of spirituality in healing.

We’re proud of what we know, which includes how much there is to learn.

Your day.

As a Government Programs PM you need to know how to:

• Support new government program implementations by attending work group meetings; preparing written updates; coordinating internal and external stakeholder meetings; completing program applications/reports, compiling information required for application process, completing required Enterprise Program Management Office (EPMO) templates for new projects; preparing and/or presenting educational materials to care sites and other System departments; and/or provide additional assistance as may be required to implement program(s).
• Collaborate with Accountable Health Analyst to develop and maintain processes for obtaining, tracking and reconciling:  incentive payments, care management fees or other performance payments received from government payers; attribution and eligibility files; and other data or documentation required for the financial performance of government programs.
• Coordinate with Accountable Health Analyst on the development and maintenance of dashboards or reports to track new government program performance. 
• Assist with compiling/completion of quality metrics if requested.
• Proactively monitor CMS and HCPF regulatory and legislative changes that impact health system operations or reimbursement.
• Support RAE and/or MA contract negotiations and issue resolution as may be requested.
• Support risk-based program development, implementation and management as programs are developed.

Your experience.

We hire people, not resumes. But we also expect excellence, which is why we require:

• Bachelor’s Degree in related field required.
• Two (2) years of experience in health care or health plan environment.
• Government/ Managed care contracting experience is required.
• Highly prefer a candidate with strong knowledge of Medicare reimbursement and/or coverage rules.

Prefer:

• Knowledge of provider and/or facility contract and payment structures, and reimbursement practices, including capitation.
• Knowledge of medical coding and terminology.
• Knowledge of managed care and/or state sponsored programs and regulations.

Your next move.

Now that you know more about our team we hope you’ll join us. At SCL Health you’ll reaffirm every day how much you love this work, and why you were called to it in the first place.