RCM/Contract Configuration Director Job in Mesa

at Nationwide Vision

Contract Configuration Director

Nationwide Vision seeks a Contract Configuration Director to join their managed care team. This is a
hands on position for interpreting the managed care contracts and calculate plan benefits to determine
accurate reimbursements due from Carriers, as well as, calculating member out-of-pocket
responsibilities at the time of service. A thorough understanding of billing and revenue cycle
management is critical. The position supervises, two configuration team members with the anticipation
of an additional 2 to 3 team members in order to support the on-going needs/growth of the company.
The Contracting Configuration Director reports to the Senior Vice President, Managed Vision Care.

Duties and Responsibilities:
 Subject matter expert – provide guidance and direction to the organization on the system
capabilities and recommended enhancements. Responsible for the systems configurations,
testing and support. Will work closely with direct reports to support plan setup and
maintenance needs.
 Partnering – this is a highly visible position within the company and interacting/partnering with
other internal support teams is a key element to ensure overall success. Validating the
configuration teams’ ability to zero balance out on plan calculations, providing the correct Net
reimbursement structure for the company with the RCM is vital.
 Office Support – partner with the training department to design and deliver required training
and support documents on all Managed Vision Care Carriers and associated different Lines of
 System Support – partner with internal users, carriers and applicable vendors to provide
escalated technical support/ troubleshooting on supporting the configuration needs of Point of
Service (POS) system.
 New Carrier implementation - develop configuration plans, lead configuration meetings, deliver
configuration project status reports to ensure all implementations and enhancements are
completed for new plan implementations as scheduled and support process development and
Carrier/plan testing is validated.

Desired Qualification:
 Bachelor’s Degree or equivalent experience, MBA or Master’s degree preferred
 Optical and/or Health care background working with plan configuration, CPT codes and
modifiers highly desirable
 5+ yrs. of experience in an application/configuration support role with at least 2/3 years as a
 At least 2-3 years managing a team (responsible for the completion of performance reviews and
hiring authority)
 Highly Desirable – Comprehensive knowledge of the SDS system