Manager, Managed Care - Systems

BJC HealthCare • Brentwood, MO

4d

About The Position

This role is responsible for ensuring Epic is accurately configured and maintained with managed care contract data. The Manager, Managed Care Systems will manage and support complex Contract Management Applications (CMA) to ensure that BJC Net Revenue is accurately reflected. This role is responsible for developing data access strategies to support contract negotiations, detailed financial analytics and special projects, including new payment methodologies. The position partners with IT and vendors as it relates to the CMA and provides key support to the Revenue Cycle Management team. The Manager will participate in RCM team meetings providing expertise to help make decisions around processes, claims issues, mapping and edits that impact the CMA application.

Requirements

• Bachelor's Degree
• 5-10 years experience
• < 2 years supervisor experience
• Experience with Epic Resolute Hospital Billing, specifically RHB390 Expected Reimbursement Contract Administration is ideal.

Responsibilities

• Manages individual(s) including but not limited to: hires, trains, assigns work, manages & evaluates performance, conducts professional development plans.
• Ensures that the productivity and actions of that group meet/support the overall operational goals of the department as established by department leadership.
• May participate in the development of departmental staffing, revenue and/or expense budgets and having direct responsibility for adhering to those goals. This includes responding to changes in the business which may affect the ability to achieve the budget goals.
• Manages and leads the maintenance of day-to-day operations of the CMA including contract loads for all payers (including, but not limited to managed care, government, direct. etc.,) interfaces, data integrity, system enhancements and vendor relations, Facilitates the resolution of contractual, interface and calculation issues in a timely manner.
• Responsible for expert level application and knowledge transfer of the CMA. Reviews complex contract payment methodologies, offer suggestions for ease of administration and participates in the decision making process.
• Manages all data mining as it relates to the CMA to support contract negotiations, ongoing operations and special projects. This includes designing, developing and implementing complex databases and comprehensive reports to provide the data in the most accurate and efficient manner in support of organizational strategies.
• Maintains collaborative working relationships with Revenue Cycle Management leaders, Corporate Finance, Government Reimbursement teams and the vendor, effectively communicating issues, concerns and changes in a timely and appropriate manner.
• Provides leadership to the team of operational professionals responsible for loading complicated contract rate terms and for overseeing system application, performance and future viability.

Benefits

• Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
• Disability insurance paid for by BJC
• Annual 4% BJC Automatic Retirement Contribution
• 401(k) plan with BJC match
• Tuition Assistance available on first day
• BJC Institute for Learning and Development
• Health Care and Dependent Care Flexible Spending Accounts
• Paid Time Off benefit combines vacation, sick days, holidays and personal time
• Adoption assistance

What This Job Offers

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