Director Reconciliation Services-HW
- Location BENTONVILLE, AR
- Department Healthcare - Corporate
- Team -
- Employment Type Full Time
- Position Salary
- Requisition 867615BR
What you'll doProvides overall direction by analyzing business objectives and customer needs; developing, communicating, building support for,
and implementing business strategies, plans, and practices; analyzing costs and forecasts and incorporating them into business
plans; determining and supporting resource requirements; evaluating operational processes; measuring outcomes to ensure
desired results; identifying and capitalizing on improvement opportunities; promoting a customer environment; and demonstrating
adaptability and sponsoring continuous learning.
Develops and implements strategies to attract and maintain a highly skilled and engaged workforce by diagnosing capability
gaps; recruiting, selecting, and developing talent; supporting mentorship, workforce development, and succession planning; and
leveraging the capabilities of new and existing talent.
Cultivates an environment where associates respect and adhere to company standards of integrity and ethics by integrating
these values into all programs and practices; developing consequences for violations or non-compliance; and supporting the
Open Door Policy.
Develops and leverages internal and external partnerships and networks to maximize the achievement of business goals by
sponsoring and leading key community outreach and involvement initiatives; engaging key stakeholders in the development,
execution, and evaluation of appropriate business plans and initiatives; and supporting associate efforts in these areas.
Evaluates the returns and risks of Health and Wellness business choices by analyzing objective financial and business data;
analyzing current outcomes to identify and communicate areas of opportunity to the billing teams or improve operational or
systematic processes; analyzing trends and patterns to determine root causes; overseeing the development of plans to increase
profitability; collaborating with contracting teams, third-party vendors, and financial services to minimize financial loss; ensuring
team identifies financial loss patterns and seeks resolutions; determining needed process changes and validating new process
improvement; working on cross-functional teams to operationalize reporting requirements; evaluating operational processes; and
measuring outcomes to ensure desired results.
Directs all functions of the reconciliation and contract management processes from concept to implementation by ensuring
contractual obligations are met; applying cross-functional knowledge and resources to produce results to support the company
strategy; collaborating and communicating with key stakeholders to determine process gaps; communicating where
inefficiencies occur; utilizing internal and external resources to apply successful business solutions; presenting immediate and
future business projections, results, risks, and needs to senior leadership; determining needed process changes, seeking
resolution, and validating new process improvements; developing models to facilitate and ensure proper controls and plan
profitability; developing new Maximum Allowable Cost (MAC) Pricing review; evaluating the financial reconciliation on our
pharmacy contracts; utilizing models and analysis to negotiate contract terms; managing the development of all reconciliation
and plan profitability reporting; and negotiating recoupment.
Oversees risk mitigation for financial reporting by ensuring division adherence to and compliance with company and legal
standards (for example, Sarbanes-Oxley); collaborating with Health and Wellness controller to ensure accuracy of accounts
receivable; ensuring cash application rules and business processes; overseeing government payment compliance; managing
audit of third-party sales reporting; determining possible areas of risk; and developing risk mitigation plans.
Serves as the contract reconciliation subject matter expert and senior advisor to the contracting group by directing and
recommending reconciliation contract terms, profitability, and reimbursements
5 years’ supervisory or cross-functional experience
Master’s degree in Business Administration, Healthcare Administration, Data Analytics, or related field
2 years’ experience pharmacy benefits management, insurance, or related field
6 years’ experience billings and receivable support
Hello, NW Arkansas
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Crystal Bridges Museum
Celebrate the American spirit in a setting that unites the beauty of art and the power of nature.
Walton Arts Center
Arkansas' premiere center for visual arts and entertainment.
An interactive children's museum that's fun for the whole family.
42 acres of premiere public garden space.
Devil's Den State Park
Located on 2,500 acres, Devil's Den State Park is the perfect place to explore Arkansas' natural beauty.
- come together
The best of shopping and restaurants, right in the heart of Fayetteville.
All the benefits you need for you and your family
- Multiple health plan options
- Vision & dental plans for you & dependents
- Associate discounts in-store and online
- Financial benefits including 401(k), stock purchase plans and more
- Education assistance for Associate and dependents