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Managed Care Contract Specialist
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$100k-134k (estimate)
Full Time 1 Day Ago
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Franciscan Missionaries of Our Lady Health System is Hiring a Managed Care Contract Specialist Near Baton Rouge, LA

Job Description
This position works in collaboration with the Vice President of Contracting and Senior Director of Payor Relations to assist with all aspects of managed care operations including contract negotiation, contract payment modeling, and contract implementation. This position acts as a liaison between Payor Relations and other internal and external entities to create seamless operational managed care performance along with maximizing payor contracting terms. The individual will be responsible for high-level, sophisticated reporting, modeling, and analyses using both hospital and professional claims data. This employee adeptly collaborates with management, operations, and administrative support teams to efficiently undertake the necessary steps crucial for successful contract negotiations. This position will make sure that negotiations are handled efficiently to meet important deadlines and remain within approved financial parameters.
Responsibilities
  1. Financial Success
    1. Lead and oversee all stages of the payor contract management cycle, ensuring timely execution and adherence to organizational parameters, contributing to financial success.
    2. Initiate and facilitate contract negotiations, focusing on securing favorable payment rates and terms to enhance organizational performance and financial outcomes.
    3. Provide thorough document management for contracts, including tracking changes and seeking input from relevant parties, ensuring accuracy and compliance with contractual obligations.
    4. Negotiate individual patient agreements to ensure optimal reimbursement and financial success for the organization.
    5. Performs high-level decision support analyses, financial modeling, and report preparation to assist with payor negotiations, resolution of claim issues, or other ad hoc requests
  2. Operational Excellence
    1. Proactively review healthcare trends to identify opportunities for operational improvement and optimization of contracts, contributing to operational excellence.
    2. Communicate complex issues effectively and represent the organization positively in various contexts, ensuring clear understanding and alignment with operational goals.
    3. Exhibit thorough attention to detail and accuracy while delivering timely work products, maintaining operational excellence in contract management.
    4. Identify and collaborate on opportunities for continuous improvement in contract management processes, including contract terms, to enhance efficiency, effectiveness, and alignment with organizational goals.
    5. Performs other job-related duties as assigned to fulfill departmental and organizational responsibilities.
Qualifications
Experience - 3-4 years of experience needed
Education - Bachelor's Degree in Business, Finance, Healthcare Administration or related field
Knowledge/Skills/Abilities - Attention to detail, Financial Acumen, Effective communication, Healthcare reimbursement, and Managed care contract negotiation

Job Summary

JOB TYPE

Full Time

SALARY

$100k-134k (estimate)

POST DATE

06/13/2024

EXPIRATION DATE

06/26/2024

WEBSITE

fmolsisters.com

HEADQUARTERS

BATON ROUGE, LA

SIZE

7,500 - 15,000

FOUNDED

1911

TYPE

NGO/NPO/NFP/Organization/Association

CEO

RICHARD R VATH

REVENUE

$3B - $5B

INDUSTRY

Skilled Nursing Services & Residential Care

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About Franciscan Missionaries of Our Lady Health System

FMOLHS owns and operates a network of healthcare centers that offers general and specialty care services.

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The following is the career advancement route for Managed Care Contract Specialist positions, which can be used as a reference in future career path planning. As a Managed Care Contract Specialist, it can be promoted into senior positions as a Contracts Administrator V that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Managed Care Contract Specialist. You can explore the career advancement for a Managed Care Contract Specialist below and select your interested title to get hiring information.