About The Position

The Managed Care and Value Based Contract Manager is responsible for contract management, including negotiation, analysis and interpretation, implementation, maintenance of contract performance, and payer relations. The role coordinates, evaluates, and oversees implementation of fee-for-service and value-based contracting and related responsibilities, population health and clinical integration strategies, government contracts, and partnering opportunities with regional employers. The position coordinates and communicates with key stakeholders and develops new and existing relationships with third-party payers to secure competitive agreements and reimbursement methodologies. The manager builds and maintains a strong Managed Care team through training, coaching, team building, and succession planning.

Requirements

  • Bachelor's degree.
  • 3–5 years of equivalent experience.

Responsibilities

  • Build and maintain a strong functional Managed Care team through effective training, coaching, team building, and succession planning.
  • Develop and implement strategies to improve the quality and efficiency of healthcare services.
  • Negotiate contracts and agreements with healthcare providers and payers to align incentives with value-based care goals.
  • Collaborate with payers to establish and monitor performance metrics and outcomes.
  • Monitor and evaluate the effectiveness of value-based care programs and interventions.
  • Facilitate communication and coordination among healthcare providers and settings to promote continuity of care.
  • Identify and implement evidence-based practices and interventions to improve patient outcomes and satisfaction.
  • Continuously seek opportunities for innovation and improvement in healthcare service delivery.
  • Perform all other duties as assigned.
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