Managed Care Contracts Manager

Piedmont Healthcare • Atlanta, GA

9d • Remote

About The Position

This is a fully remote opportunity Responsibilities Manages the day-to-day Managed Care operations and contracting activities across the system. Plans and directs managed care operational practices including analyzing, negotiating and maintaining system wide Managed Care agreements. Monitors and updates Vice President on political, legal and regulatory trends with respect to managed care and vertical integration. Works with and oversees Medical Economics, Decision Support and Revenue Cycle operations to produce reports concerning managed care contract performance and operations. Plans and oversees education for Patient Financial Services (PFS) and applicable Revenue Cycle departments throughout the system in order to educate departments concerning contract terms, language and compliance. Facilitates resolution of contractual and operational issues with payers in order to enhance managed care contract performance. Contributes to the implementation of managed care vision and goals.

Requirements

• Bachelor’s Degree from a recognized college or university in healthcare, managed care contracts, or related field Required or In Lieu of degree eight (8) years of experience in healthcare, managed care contracts, or related field Required
• 5 years experience in Managed Care contract negotiations or related activities Required or In lieu of degree 13 years of experience in healthcare, managed care contracts, or related field Required

Nice To Haves

• Hospital and payer experience Preferred

Responsibilities

• Manages the day-to-day Managed Care operations and contracting activities across the system.
• Plans and directs managed care operational practices including analyzing, negotiating and maintaining system wide Managed Care agreements.
• Monitors and updates Vice President on political, legal and regulatory trends with respect to managed care and vertical integration.
• Works with and oversees Medical Economics, Decision Support and Revenue Cycle operations to produce reports concerning managed care contract performance and operations.
• Plans and oversees education for Patient Financial Services (PFS) and applicable Revenue Cycle departments throughout the system in order to educate departments concerning contract terms, language and compliance.
• Facilitates resolution of contractual and operational issues with payers in order to enhance managed care contract performance.
• Contributes to the implementation of managed care vision and goals.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 5,001-10,000 employees