Manager Managed Care Contracts - Hybrid
Manager Managed Care Contracts - Hybrid
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Job Description
About Us
AtCooper University Health Care our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities equipment technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs. Cooper offers full and part-time employees a comprehensive benefits program including health dental vision life disability and retirement. We also provide attractive working conditions and opportunities for career growth through professional development.
Discover why Cooper University Health Care is the employer of choice in South Jersey.
Short Description
The Manager of Managed Care Contracting will be responsible for the following functions:
Craft evaluate negotiate and execute a wide variety of different contracts covering a range of transactions for hospital and physician entities.
Create and maintain relationships with external stakeholders (payers) and internal stakeholders (billing finance legal physicians administration) and serve as the singular point of contact for matters concerning contracts.
Maintain records for correspondence and documentation in relation to established contracts and those in progress; ensure contract library remains current.
Communicate and present information to stakeholders about all contract-related matters.
Monitor contracts and move forward with close-out extension or renewal according to whats best for the company.
Solve any contract-related problems that may arise with other parties and internally with the company itself; this includes tracking and monitoring data as it relates to outstanding settlements/projects for payer payment issues.
Manage and maintain reporting regarding payor trends contract compliance and contract modeling either through Epic Strata or other reporting source. Epic certification may be required.
Responsible for completing facility recredentialing applications.
Be cognizant of all state and federal regulatory aspects.
Establish processes to meet organizational and departmental goals.
Experience Required
4-7 years experience in responsible positions in health care or health plan environment with financial and managed care contracting experience. The individual must have experience in the negotiating/contracting process including a strong ability to organize and prioritize activities while ensuring attention to details. The Manager of Managed Care Contracts successful candidate will assist the Director of Managed Care in system design integrating activities communicating results of payor negotiations/issues and maintaining effective relationships with operating entities and physicians. Epic experience desired.
Education Requirements
Graduation from an accredited college or university with a degree in Business Finance Management or Healthcare is required. A masters degree in business administration or health care administration is preferred or the equivalent in experience.
Special Requirements
The individual requires an understanding of health plans managed care delivery systems and/or alternative financing systems as well as knowledge of relevant federal and state regulations. The candidate will be responsible for developing processes to assure all relevant state and federal regulations are in compliance with all parties for all insurance carriers. This individual must demonstrate an understanding of basic financial principles and data systems. The position requires extensive knowledge of the managed care environment negotiation process and contracting principles. Experience in negotiating contracts with payers is desired.
Salary Min ($)
Salary Max ($)
Required Experience:
Manager
Employment Type
Unclear
