Manager - Managed Care Financial Operations

ACCESS Community Health Network • Chicago, IL

16h

About The Position

If you want to work for a mission-driven organization that’s impacting community health care both on a local and national level, then Access Community Health Network (ACCESS) may be the perfect place for you. As a nationally recognized leader in community health, we continue to innovate and improve our integrated care model to address the total health and wellness of our patients. Our dedicated staff are committed to advancing health equity and making a long-term impact on the health outcomes of the more than 150,000 patients that count on ACCESS as their medical home each year.
Position Summary
The Manager, Managed Care Financial Operations manages the daily operations of the Managed Care Department, including a team and processes to design, analyze, negotiate, implement, and monitor managed care contracts.

Requirements

• Bachelor’s degree
• Minimum of 3 years’ experience in a healthcare provider or managed care operations
• Minimum 2 years’ experience managing staff
• Intermediate proficiency in Microsoft Office (especially in Word, Excel, and PowerPoint)

Nice To Haves

• Degree in health or business field
• Experience negotiating contracts and terms
• Experience in financial modeling

Responsibilities

• Manage day to day interactions with health plans. Collaborate with other departments to understand and communicate issues to health plans
• Responsible for the review and monitoring of managed care contracts including compliance to contract terms, requirements from provider manuals and any other related contractual documents; performs audits based on contractual agreement and establishes corrective action plans as necessary.
• Ensures managed care contracts are in support of ACCESS care model and associated standard access to care, care coordination, case management, quality metrics
• Responsible for reviewing managed care contract information and creating materials to help disseminate new and/or updated information to a variety of ACCESS audiences.
• Provide data analysis and performance reporting in support of managed care contracts and program efforts, including financial modeling
• Manages day to day claims processing operations
• Manage direct reports, communicating expectations, providing coaching and feedback, monitoring and managing performance and providing development opportunities

Benefits

• Tuition reimbursement and student loan forgiveness programs for qualifying individuals
• Comprehensive healthcare coverage including Medical, Dental, and Vision
• Generous PTO after introduction period
• 403(B) retirement plan and financial resources to help you save and plan for your retirement
• Life Insurance
• Opportunity to participate in cross-departmental committees to innovate and transform our care delivery model and our workplace

What This Job Offers

• Job Type: Full-time
• Career Level: Manager