What are the responsibilities and job description for the Manager, Managed Care position at Adventist Health?
Job Description
Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.
Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.
Job Summary
Manages and supports regional managed care contracting and recovery activities. Negotiates health plan (managed care) contracts with payers as assigned across the system. Supervises and directs the activities of various levels of assigned personnel using both professional and supervisory discretion and independent judgment.
Job Requirements
Education and Work Experience:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.
About Us
Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.
Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.
Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.
Job Summary
Manages and supports regional managed care contracting and recovery activities. Negotiates health plan (managed care) contracts with payers as assigned across the system. Supervises and directs the activities of various levels of assigned personnel using both professional and supervisory discretion and independent judgment.
Job Requirements
Education and Work Experience:
- Bachelor's Degree or equivalent combination of education/related experience: Required
- Master's Degree: Preferred
- Five years' technical experience: Preferred
- One year's leadership experience: Preferred
- Reviews and evaluates contract performance models for renewal/ renegotiation. Maintains responsibility for contract implementation, internal and external in-servicing of contract terms.
- Supports executive management in negotiations and revenue recovery activity with payers. Coordinates and facilitates Joint Operations Meetings with payers and affiliated partners.
- Collaborates with management and top professionals/specialists in selection of methods, techniques and analytical approach. Provides day-to-day technical leadership while performing escalated or complex duties. Provides oversight of employees within the work group using advanced technical skills.
- Conducts performance reviews and provides input on direct reports for human resource decisions such as hiring, promotions and disciplinary actions. Participates in the development of employees.
- Maintains responsibility for adherence to budget for specific projects. Participates in the preparation of the department budget.
- Performs other job-related duties as assigned.
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.
About Us
Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.