What are the responsibilities and job description for the Managed Care Manager position at Nearterm Corporation?
Multi Facility organization that is growing and has excellent hospital ratings and employee satisfaction scores.
The leader has operational accountability and oversight, and manages the daily operational contract management activities of the Managed Care department. In this role, the leader sets the tone and models positive leadership behavior, while ensuring successful completion of teamwork tasks, projects, and responsibilities in support of departmental and organizational goals.
- Must have experience with negotiation of contracted rates and language including redlining of contracts.
- Must be knowledgeable of all aspects of a health care delivery system, industry contracting practices and administration, and
- contract analysis.
- EExperience in organizational and time management skills to maximize productivity and outcomes.
- Must be proficient in PC-based software, the ability to instruct staff on complex analysis, and develop complex reports.
- Excellent written and oral communication skills, to include composing contract language correspondence, patient correspondence and reports.
- Proficiency in payment methodologies such as DRG, APR-DRG, Case Rates, EAPG, Per Diems, and Fee Schedules.
- Ability to build and maintain effective relationships with payors and leverage interpersonal influences to achieve organizational goals.
- Must build strong relationships and deliver high quality service to all internal and external customers.
- Provide leadership and mentoring by guiding individuals and teams towards desired outcomes, setting high performance standards and delivering industry-leading quality services.
Education Requirements:
Require a bachelor's degree in business, accounting, finance, or other relevant field of study. Master's degree is preferred.
Require a minimum five (5) years of managed care contracting experience in a similar size healthcare system or large healthcare payer.