Managed Care Administrator
About The Position
This position will manage the DMH/DD/SUS Managed Care Administration Team (“Managed Care Admin Team”). The Managed Care Admin Team oversees the contractual and cross-division administrative functions related to overseeing Tailored Plans for the Division, and where applicable Prepaid Inpatient Health Plans, Standard Plans, and the Child and Family Specialty Plan. These functions include management of contract amendment processes, monitoring of contractual requirements, communication and coordination with NC Medicaid (and other relevant DHHS section) and the respective Plans, and providing technical assistance to DMH/DD/SUS staff in understanding Plan functions and requirements.
Requirements
- Master's degree in the area of assignment from an appropriately accredited institution and three years of experience in a closely related program; or Bachelor's degree in the area of assignment field from an appropriately accredited institution and five years of experience in a closely related program; or an equivalent combination of education and experience.
Nice To Haves
- Demonstrated understanding of managed care operations, Tailored Plans (formerly LME/MCOs)
- Demonstrated understanding of the policies, procedures, and funding mechanisms of managed care in North Carolina
- Demonstrated skill in contract monitoring, planning, and communication.
Responsibilities
- Manage the DMH/DD/SUS Managed Care Administration Team (“Managed Care Admin Team”).
- Oversee the contractual and cross-division administrative functions related to overseeing Tailored Plans for the Division, and where applicable Prepaid Inpatient Health Plans, Standard Plans, and the Child and Family Specialty Plan.
- Manage contract amendment processes.
- Monitor contractual requirements.
- Communicate and coordinate with NC Medicaid (and other relevant DHHS section) and the respective Plans.
- Provide technical assistance to DMH/DD/SUS staff in understanding Plan functions and requirements.
Benefits
- health insurance options
- standard and supplemental retirement plans
- NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis)
- paid vacation
- sick leave
- community service leave
- paid parental leave
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What This Job Offers
Job Type
Full-time
Career Level
Manager
