Managed Care Operations Administrator

VHC Health•Alexandria, VA

10d•$78,582 - $143,000•Onsite

About The Position

The Managed Care Operations Administrator serves as the day-to-day liaison between the hospital and its contracted health plans. This role involves developing and maintaining relationships with health plan liaison personnel, gathering information on health plan policies and procedures that affect hospital services and reimbursement, and maintaining updated reference materials for employees. The administrator ensures operations staff have access to and training on health plan online systems, provides focused training to departments on managed care contracts and policies to improve compliance, and develops materials and conducts training on EPIC payers and plans to enhance registration accuracy. The primary purpose is to provide a focused resource for daily operational issues, training, and process improvement, while also assisting the Managed Care Operations Director with their duties.

Requirements

Bachelor's degree in healthcare management or a related field.
Five years of provider or payor healthcare experience.

Nice To Haves

Master's degree in healthcare administration, business, or equivalent experience.

Responsibilities

Serve as the day-to-day liaison between the hospital and contracted health plans.
Develop and maintain relationships with health plan liaison personnel.
Gather information on health plan policies and procedures from various sources.
Maintain and update reference materials for employees.
Ensure operations staff have access to and training on health plan online systems.
Provide focused training to departments on managed care contracts and health plan policies.
Develop materials and conduct training on EPIC payers and plans.
Provide a focused resource for day-to-day operational issues, training, and process improvement.
Assist the Managed Care Operations Director in their duties.