Manager of Managed Care

About the role

The Manager of Managed Care is responsible for overseeing the management and maintenance of managed care contracts and related databases to ensure accuracy, compliance, and accessibility across the organization.

Responsibilities

• Oversees the managed care contract database, including contract entry, reporting, face sheets, and system administration.
• Supervises and trains contract analysts, facility contract specialists, and temporary staff on contract entry, database utilization, and reporting processes.
• Compiles, prepares, and distributes managed care contract reports and executive summaries for leadership and facility stakeholders.
• Serves as liaison with Information Technology, Business Solutions, and database support teams to ensure timely implementation of process improvements and resolution of database issues.
• Translates and inputs contract language, reimbursement rates, and terms into the managed care contract database.
• Develops and maintains user guidelines, forms, and training materials for database utilization and reporting.
• Provides reports and contract information to corporate departments, facilities, and external partners, ensuring accuracy and compliance.
• Oversees the preparation and coordination of contract assignments, notices, and documentation related to divestitures, legal matters, and arbitrations.
• Coordinates and maintains quality grids and other contract-related reporting tools used by leadership and clinical stakeholders.
• Initiates and documents departmental contracting processes, guidelines, and standards.

Leadership Responsibilities

• Provides leadership, mentorship, and professional development opportunities for departmental staff.
• Schedules employees to ensure effective use of resources and consults with Director on staffing issues.
• Conducts performance evaluations, sets goals, and provides feedback to staff on their performance and development.
• Develops and manages departmental budget, ensuring cost-effective operations while maintaining high-quality service.
• Monitors expenditures, ensuring cost-effective delivery of services, and evaluates and implements new technologies to enhance operational efficiency.
• Develops and implements departmental policies and procedures and protocols to optimize quality and overall efficiencies.
• Ensures compliance with all relevant regulatory bodies and participates in audits, inspections, and accreditation processes as applicable.

Qualifications

Bachelor's Degree in relevant field required, or four (4) plus years of direct experience in lieu of a Bachelor's degree required. Master's Degree preferred. 2-4 years of experience in a closely related field with a Bachelor's degree required, and 2-4 years of previous leadership experience preferred.

Skills

• Strong leadership, organizational, and communication skills.
• Ability to collaborate with interdisciplinary teams and manage cross-functional relationships.
• Foster a positive work environment that promotes teamwork, professionalism, and continuous improvement.
• Communicate effectively with leadership, team members, and stakeholders.
• Ability to work effectively with others, delegate responsibilities, and independently manage tasks while meeting established deadlines.
• Problem-solving and critical thinking skills.
• In-depth knowledge of industry best practices and regulatory compliance (if applicable).
• Strong organizational and time management skills.
• Proficiency with Google and Microsoft platforms, healthcare software systems, and data analysis tools.

Benefits

• Competitive Compensation – Salary and benefits package designed to reward expertise, leadership, and contributions.
• Comprehensive Health Coverage – Medical, dental, vision, and life insurance options to support you and your family.
• Future Security – 401(k) retirement plan with employer matching to help build long-term financial stability.
• Generous Paid Time Off – Paid Time Off (PTO) and Extended Illness Bank (EIB) to support work-life balance and personal well-being.
• Career Growth Opportunities – Professional development, leadership training, and advancement opportunities across the organization.
• Recognition & Reward Programs – Celebration of employee achievements and contributions to success.
• Exclusive Employee Discounts & Perks – Access to special savings and benefits designed for team members.