Managed Health Contract Manager
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Job Summary
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Monday - Friday 8 - 5
Pay Range
$35.50 - $53.25Essential Functions
- Assist in the development and implementation of strategies and objectives related to managed care contracting for assigned Managed Care Organizations.
- Responsible for rate and language negotiation of assigned minor payor agreements. Support Director/AVP support for rate and language negotiations of major payor agreements. Assist with the development of negotiation strategy for major payors. Negotiate rate and language of small to mid-size payor agreements.
- Monitor regularly review and report financial and operational performance of assigned payor contracts versus expectations. Recommend any action needed as a result of contract performance.
- Understand and identify current risks and sources of exposure Primary Enterprise.
- Gather and analyze data and apply methodologies. Draw preliminary conclusions and project application(s). Identify cross-application of data or analysis directing efforts of other associates as needed.
- Maintain current detailed working knowledge of all assigned payor contracts and manage System relationship with such payors.
- Creates and implements based on Management feedback and information supplied by other System entities managed care contracting policies and procedures to maximize System performance in managed care relationships.
- Provide System with accurate and current managed care market intelligence by maintaining a working understanding of local/regional/national trends conducting competitive market assessments staying abreast of changes and impact of regulatory environment staying abreast of changes and impact of payor initiatives including responses to new products entering the marketplace and provide other information to support division reporting initiatives.
- Provide education on new agreements as they affect stakeholders via written communications or presentations as needed. Anticipate and address hospital CFO needs for information resulting from new or modified agreements.
- Develop and maintain cooperative internal working relationships with all parts of the Total Enterprise to effectively evaluate and assess overall impact of contracting initiatives. Serve as MHR Contracting point person for assigned entities.
- Proactively work with Managed Care Analytics to report and refine reporting of contract performance analysis and modeling tools.
- Work closely with Managed Care Specialist and Managed Care Senior Specialist on operational issues that become contract issues. This includes attendance at payor Joint Operating Committee (JOC) meetings.
Perform most work under normal office conditions; may include sitting for long periods of time standing walking using repetitive wrist/arm motion or lifting articles up to twenty-five pounds.
Education Experience and Certifications.
Bachelors degree required Masters degree preferred (MBA or MHA preferred).Minimum of 3 years experience as a contract negotiator with a large provider or 5 years small provider or payor experience as a contract negotiator with a Bachelors degree. -OR- Minimum of 2 years experience as a contract negotiator with a large provider or 4 years small provider or payor experience as a contract negotiator with a Masters degree.
Our CommitmenttoYou:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs competitive compensation generous retirement offerings programs that invest in your career development and so much more so you can live fully at and away from work including:
Compensation
- Base compensation listed within the listed pay range based on factors such as qualifications skills relevant experience and/or training
- Premium pay such as shift on call and more based on a teammates job
- Incentive pay for select positions
- Opportunity for annual increases based on performance
Benefits and more
- Paid Time Off programs
- Health and welfare benefits such as medical dental vision life andShort- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
About Advocate Health
Advocate Health is the third-largest nonprofit integrated health system in the United States created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas Georgia and Alabama; and Aurora Health Care in Wisconsin Advocate Health is a national leader in clinical innovation health outcomes consumer experience and value-based care. Headquartered in Charlotte North Carolina Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology neurosciences oncology pediatrics and rehabilitation as well as organ transplants burn treatments and specialized musculoskeletal programs. Advocate Health employs 155000 teammates across 69 hospitals and over 1000 care locations and offers one of the nations largest graduate medical education programs with over 2000 residents and fellows across more than 200 programs. Committed to providing equitable care for all Advocate Health provides more than $6 billion in annual community benefits.
Required Experience:
Manager
Key Skills
- Facilities Management
- ADMA
- Heavy Bus Driving
- AXA
- Building Services
- Courier Delivery
About Company
Proudly serving Wisconsin with 18 hospitals, over 150 clinics and 70 pharmacies across 30 communities. Choose Aurora Health Care for you and your family.
