Thank you for considering a career at Ensemble Health Partners!
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.
Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference
The Opportunity:
The primary role of the Contract Modeling Specialist level II is to support client needs relative to contract management with a minimum of 2 years Epic certification and experience. The specialist II will be responsible for support functions such as contract loading, contract validation, trouble shooting and training. The specialist II will actively participate with the Contract Management knowledge share opportunities to expand their knowledge base and role along with assisting in expanding the knowledge of their peers by assisting with training and other knowledge share opportunities.
- Maintain an active Epic certification in Epic Contract Management for RHB390 (acute) and/or RPB390 (physician).
- Conduct file balancing and daily maintenance of contract management system based on client/system need.
- Collaborates with Ensemble Clients to assist with inquiries related to contract accuracy and/or potential reimbursement issues.
- Provide support to Contract Modeling Specialists for trouble shooting (including contract review and/or Epic system navigation).
- Maintains a schedule of key update dates for expected reimbursement rules, such as Medicare OP quarterly updates, yearly Diagnostic Related Group (DRG) updates, and yearly increases for the Managed Care contracts utilizing such tools as a Smartsheet for tracking.
- Uses modeling tools and reports to identify and confirm validity of payment variances for referral to the underpayments team for appeal and/or follow-up.
- Provide support to other revenue cycle areas regarding questions on calculations and reimbursement.
- Completes necessary training modules and work building sessions to become fluent in contract loading for the client host system, Epic.
- Provide ongoing contract validation to support client financial initiatives, including expected reimbursement based reserve calculations for budgeting purposes.
- Coordinates and actively participates with other associates and leaders on the team to expand and grow their knowledge of managed care organizations, contracts, and the Epic system.
- Knowledgeable in the interpretation of Epic product upgrade Nova Notes and completion of any needed Contract build related to them.
- Efficient in the import/export of Epic databases for use in reporting, troubleshooting, and other related tasks.
- Proficient in the use of Epic supplied Toolkits for Medicare OP and IP quarterly and annual updates.
Education Requirements:
High School Diploma or GED
Licensure/Certification Required:
- Epic RHB390 or Epic RPB390 Contract Administration Certification
HFMA Certified Revenue Cycle Representative
Minimum Years and Type of Experience:
- 2 years’ experience relative to payer reimbursement with a minimum of 2 years Epic certification in RHB390 or RPB390 Epic certification.
Other Knowledge, Skills and Abilities Required:
Knowledge of managed care organizations, contracts, and products or applicable healthcare or payer experience relative to position. Requires a high level of problem-solving ability, initiative and judgment. Requires the ability to work in a fast-paced environment balancing multiple priorities and utilizing resources aggressively. Requires the ability to understand and interpret all aspects of a contract with an emphasis on the implementation and operational components of contract terms. Must be a self-starter with the ability to identify, understand, research, and solve unique and complicated financial and operational provider issues as it relates to their specific contracts.
Microsoft Excel proficiency is recommended. EPIC and/or other contract management software. Excellent interpersonal skills are necessary to develop strong working relationships with internal and external contacts.
Join An Award-winning Company
Three-time winner of “Best in KLAS” 2020-2022
2022 Top Workplaces Healthcare Industry Award
2022 Top Workplaces USA Award
2022 Top Workplaces Culture Excellence Awards
- Innovation
- Work-Life Flexibility
- Leadership
- Purpose + Values
Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:
- Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
- Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
- Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
- Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.
Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact TA@ensemblehp.com.
This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.
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