Manager of Managed Care Operations
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Job Location:
Chicago, IL - USA
Monthly Salary:
Not Disclosed
Posted on:
18 hours ago
Vacancies:
1 Vacancy
Job Summary
Keystone Advisors is looking for a Manager of Managed Care Operations to support one of our healthcare clients in the Illinois Medical District in the West Loop of Chicago.Compensation Package:
Job Summary:
The Manager of Managed Care Operations works collaboratively with staff at managed care plans as well as internal hospital departments such as Revenue Cycle Finance and Data Analytics to implement managed care strategies that maximize the financial success of managed care contracts. The Manager of Managed Care Operations will be responsible for assisting the Director with contract negotiations and ensuring that requirements and initiatives are successfully executed resulting in improved access to contracted services improved outcomes and increased profitability.Typical Duties:
- Assists the Managed Care Director with negotiations for both fees for service & value-based care agreements through the use of financial analysis and contract languagereviews.
- Maintains relationships with Payers and works to resolve contract compliance issues by working closely with revenue cycle leadership to ensure revenue streams are not disrupted.
- Assists the Managed Care Director with the oversight of contracted managed payers.
- Develop and oversee the implementation of strategies to improve managed careperformance in terms of utilization patient access cost compliance with contractual quality measures etc. Align improvement with quality and financial goals.
- Contribute to the management of department staff and employees systemic development and success.
- Discuss and develop system policies and procedures.
- Consistently use independent judgment to identify operational staffing issues and needs and perform the following functions as necessary; hire transfer suspend layoff recall promote discharge assign direct or discipline employees pursuant to applicable policies.
- Other duties as assigned.
Knowledge Skills Abilities and Other Characteristics:
- Must understand healthcare contracting including financial analysis credentialing legal review Value Based Care and utilization data.
- Effective communication skills both written and verbal as well as the ability to exercise judgement when working with individuals with different points of view on a critical issue.
- Excellent presentation and negotiation skills
- Ability to maintain confidentiality of all patient information per HIPAA requirements.
- Knowledge and high level of proficiency in Microsoft Office software suite.
- Strong interpersonal and leadership skills to lead and direct the Managed Care department.
Minimum Qualifications:
- Bachelors degree from an accredited university.
- Five (5) years of managed care work experience within a health system managed care organization or consulting firm.
- Strong leadership and negotiation skills. Knowledge of managed care contracting rates for network providers services and facilities.
- Advanced ability to operate computers and related software for Microsoft programs including Word Excel Outlook.
- Sound financial acumen and the ability to analyze and interpret financial reports and metrics.
- Proven ability to build and maintain strong relationships with vendors and internal stakeholders.
Preferred Qualifications:
- Masters degree in business administration health administration or finance from an accredited college or university.
Compensation Package:
Competitive Salary
Paid Time Off
Health Vision & Dental Insurance
Health Savings Account (HSA)
Flexible Spending Account (FSA)
Short & Long Term Disability
401(K)
Life Insurance
Required Experience:
Manager
Key Skills
- Risk Management
- Negiotiation
- Operational management
- Smartsheets
- Strategic Planning
- Team Management
- Budgeting
- Leadership Experience
- Program Development
- Supervising Experience
- Financial Planning
About Company
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