Contracting Strategies

Payor Strategies & Market Opportunities oversees contract negotiations with managed care plans, direct employers and other third party payors on behalf of UTMB providers and health care facilities. Through these relationships, individuals and employers in the greater southeast Texas area have access to UTMB's health care services. They are also responsible for directing and managing the pricing and reimbursement strategies for all UTMB providers and they assists with the Health System's strategy and approach to market growth.

Contract Administration coordinates efficient and risk-appropriate contracting practices across the institution by maintaining consistent contracting parameters, ensuring appropriate financial terms, and merging other relevant information to support informed contracting decisions. Contract Administration also coordinates the delegation of institutional signatory authorities and manages the process of acquiring Board of Regents approval for significant contracts and other related matters.

The provider enrollment team is responsible for enrolling UTMB faculty providers into Medicare, Medicaid, and the Managed Care and Managed Medicaid plans that are contracted with UTMB. In addition, they serve as liaison between the billing department and managed care plans to resolve billing issues related to provider enrollment.

The Revenue Integrity team is responsible for maintaining the integrity of the UTMB charge description master for both professional services and the health system's clinics and facilities, including pricing oversight, compliance, and review.