Managed Care Manager

Job Summary

The Manager, Managed Care will oversee and direct operations of the Managed Care Contracting, Denials & Underpayments, and Denials Management teams. Key responsibilities include developing and implementing strategies to optimize managed care contracts, resolving payer denials and underpayments, and ensuring compliance with regulatory and contractual obligations.

Responsibilities

• Engage payer leadership to resolve denials and underpayments and implement systemic improvements
• Drive continuous improvement initiatives to enhance operational efficiency and financial performance
• Ensure timely reporting on financial analysis of reimbursement, denial trends, and contract performance

Requirements

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, or related field required; Master's degree preferred
• Minimum 10 years’ progressive experience in healthcare financial field
• At least 5 years’ supervisory or management experience with proven leadership in team development

Qualifications

• In-depth knowledge of managed care contracting principles and negotiation strategies
• Understanding of healthcare billing, denial management, and appeals processes
• Excellent knowledge of MS Office and familiarity with relevant computer software
• Strong team leadership skills, strong organization, interpersonal, and customer relations skills
• Must be able to meet strict deadlines
• Strong analytical and problem-solving ability, and excellent organizational skills
• Ability to complete multiple tasks simultaneously
• Able to remain calm in difficult situations
• Strong written and oral communication skills, proficient computer skills, proven track record of successful performance
• Ability to understand complex multifactor situations and bring appropriate solutions
• Ability to work both independently and in a team environment

Benefits

Baptist Health offers competitive benefits including health insurance, retirement plans, and paid time off.

Pay

Compensation is commensurate with experience.

Schedule

This is a full-time position with a first shift schedule.