Managed Care

4 weeks ago


Santa Fe Springs, United States College Health Enterprises Full time

College Health Enterprises is one of the fastest growing health systems in Southern California. We are dedicated to the highest quality of customer services delivered with a with a sense of warmth friendliness and organizational pride. Become part of a team that provides a respectful environment, flexibility, a tight knit group and autonomy to utilize your knowledge and experience.

**Job Summary**:
College Health Enterprises is searching for a Managed Care Contracts Manger. You will develop and negotiate hospital and professional service Managed Care contracts in accordance with established rate and language parameters. This will involve modeling, compiling, and analyzing volumes and financial data for clinical services and case types. You will manage a portfolio of Managed Care contracts and will assume a leadership role in facilitating contract implementation within key operational areas throughout the organization.

**Qualifications**:

- Build and nurture strong relationships with health plans, medical groups, and other third-party payors
- Work effectively with all internal and external parties to resolve contract-related operational issues in a timely manner.
- Related Bachelor’s degree preferred
- Experience with a healthcare provider organization
- Advanced managed care contract negotiation skills, preferably within a hospital, medical group, or health plan environment
- Understanding of the Southern California managed care marketplace
- Knowledge of hospital and professional reimbursement mechanisms
- Ability to work with hospital/clinical departments to implement negotiated contracts
- Commercial, Medicare, and Medicaid contracting experience a plus
- **Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for CHE, including but not limited to shift differential and other special pay practices, etc. The posted compensation for the position is a reasonable estimate that extends from the lowest to the highest pay that CHE in good faith believes it might pay for this particular job, based on the circumstances at the time of posting.**_

Pay: $80,000.00 - $105,000.00 per year

**Benefits**:

- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance

Schedule:

- Day shift
- Monday to Friday

Work Location: In person



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