Healthcare Manager

7 days ago


Ladson, South Carolina, United States Roper St. Francis Full time
Job Summary

Roper St. Francis Healthcare is seeking a skilled Healthcare Manager to join our team. As a key member of our managed care team, you will be responsible for implementing and overseeing the daily operations of managed care programs and initiatives. This role requires strong leadership and communication skills, as well as the ability to analyze data and make informed decisions.

Key Responsibilities
  • Oversee the daily operations of managed care arrangements, including value-based arrangements, ensuring compliance with contractual agreements and regulatory requirements.
  • Monitor and evaluate the performance of managed care initiatives.
  • Support (and lead certain) managed care contract negotiations and contract-related issues and disputes.
  • Manage the Provider Credentialing/Enrollment process.
  • Act as a liaison between RSFH and payors, health plans, and other managed care entities.
  • Analyze data related to patient care, utilization, and cost to identify trends and opportunities for revenue improvement.
  • Prepare and present reports on managed care performance, including financial performance and quality metrics.
  • Supervise and mentor payor credentialing and enrollment staff, providing guidance, support, and professional development opportunities.
  • Coordinate with other departments to ensure seamless integration of managed care processes with overall organizational goals.
Requirements
  • Bachelor's degree in accounting, finance, or related field.
  • Master's degree in business or healthcare administration preferred.
  • Five years of provider experience as a contract negotiator.
  • Payor or healthcare system experience.
What We Offer
  • Comprehensive, affordable medical, dental, and vision plans.
  • Prescription drug coverage.
  • Flexible spending accounts.
  • Life insurance w/AD&D.
  • Employer contributions to retirement savings plan when eligible.
  • Paid time off.
  • Educational Assistance.


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