Managed Care Contract Specialist
4 days ago
ProMedica Health System is seeking a highly skilled Managed Care Contract Specialist to join our team. As a key member of our Managed Care team, you will be responsible for developing and implementing managed care strategies and relationships designed to maintain and grow our network of hospitals, primary care and specialty providers, and a clinically integrated network.
Key Responsibilities:- Operate as team lead responsible for all behavioral health and vision agreements and managing the relationships with those managed care payors and behavioral health agencies.
- Manage payer issues that are escalated to Managed Care and ensure each is resolved in a timely and appropriate manner.
- Lead interdisciplinary team of key stakeholders involved in analyzing relevant data to identify industry changes and policies made to managed care contracts and reimbursement.
- Negotiate and manage administration of all value-based agreements.
- Graduate of an accredited college or university in Health Care Administration, Business, Finance or similar field.
- Experience negotiating managed care contracts in a health system, consulting firm, or with a managed care payor preferred.
- Knowledge of Ohio and Michigan insurance payors required.
- Knowledge of basic Microsoft Office tools required.
- Master's degree.
- Understanding of PHS information systems preferred.
- Advanced knowledge of Microsoft Office tools.
ProMedica is a mission-based, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio. We are an equal opportunity employer and welcome applications from diverse candidates. If you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact us.
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