Healthcare Manager
2 days ago
Job Summary
The Manager of Managed Care provides strategic, tactical, operational oversight and coordination for developing, recommending and executing the Hospital's Managed Care agreements, contract performance analysis and ensuring provisions of high quality, customer focused, and cost-effective contract administration. Responsible for identifying and coordinating business development opportunities by serving as a liaison and advocate to the Medicare eligible population in the education of hospital services available.
Key Responsibilities
Contract Management
• Develop and execute managed care agreements to ensure high-quality, cost-effective contract administration.
Business Development
• Identify and coordinate business development opportunities to expand hospital services.
Liaison and Advocacy
• Serve as a liaison and advocate to the Medicare eligible population to educate them on hospital services available.
Operational Oversight
• Provide strategic, tactical, and operational oversight to ensure effective contract administration.
Requirements
Work Experience
• Five years of related experience in managed care contracting.
Education and Training
• Bachelor's Degree in Business Administration or a health-related field required, Master's degree preferred.
Skills
- Excellent analytical skills, negotiation skills, and knowledge of reimbursement methodologies.
- Knowledge and understanding of the healthcare industry and government reimbursement methodologies, including Medicare and Medicaid.
- Possesses a detailed understanding of financial aspects of rates of return and break-even points, as applied to specific business models at the organizational level, or service line.
- Ability to adapt to and use information system tools available to fulfill job requirements.
- Leadership ability, communications, and interpersonal skills necessary to interact effectively with physicians, management, staff, external agencies/customers, and patients/families.
- Solid organization and contract management skills.
- Ability to collect/analyze data to communicate and negotiate terms and provisions related to hospital, physician, and clinic contracts with insurance companies and other third parties.
- Knowledgeable on Medicare benefits, regulations, and all associated, relevant Medicare data.
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