Mgr Managed Care Contracts
Remote · USFull-timePosted todayStill listed today
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Requirements
Credentials this posting asks for.
Job overview
The manager oversees day-to-day Managed Care operations and contracting across the system, directing operational practices, analyzing and negotiating agreements, and monitoring political, legal, and regulatory trends. They collaborate with Medical Economics, Decision Support, and Revenue Cycle teams to produce performance reports, educate departments on contract terms, and resolve payer issues to enhance contract performance.
Skills & qualifications
Qualifications
Full job description
Overview Manages the day-to-day Managed Care operations and contracting activities across the system. Plans and directs managed care operational practices including analyzing, negotiating and maintaining system wide Managed Care agreements. Monitors and updates Vice President on political, legal and regulatory trends with respect to managed care and vertical integration. Works with and oversees Medical Economics, Decision Support and Revenue Cycle operations to produce reports concerning managed care contract performance and operations. Plans and oversees education for Patient Financial Services (PFS) and applicable Revenue Cycle departments throughout the system in order to educate departments concerning contract terms, language and compliance. Facilitates resolution of contractual and operational issues with payers in order to enhance managed care contract performance. Contributes to the implementation of managed care vision and goals. Responsibilities Manages the day-to-day Managed Care operations and contracting activities across the system. Plans and directs managed care operational practices including analyzing, negotiating and maintaining system wide Managed Care agreements. Monitors and updates Vice President on political, legal and regulatory trends with respect to managed care and vertical integration. Works with and oversees Medical Economics, Decision Support and Revenue Cycle operations to produce reports concerning managed care contract performance and operations. Plans and oversees education for Patient Financial Services (PFS) and applicable Revenue Cycle departments throughout the system in order to educate departments concerning contract terms, language and compliance. Facilitates resolution of contractual and operational issues with payers in order to enhance managed care contract performance. Contributes to the implementation of managed care vision and goals. Qualifications
Education
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Bachelor’s Degree from a recognized college or university in healthcare, managed care contracts, or related field Required or
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In Lieu of degree eight (8) years of experience in healthcare, managed care contracts, or related field Required
Work Experience
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5 years experience in Managed Care contract negotiations or related activities Required or
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In lieu of degree 13 years of experience in healthcare, managed care contracts, or related field Required
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Hospital and payer experience Preferred
Business Unit : Company Name Piedmont Healthcare Corporate
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