Mgr Managed Care Contracts
Overview
Manages the day-to-day Managed Care operations and contracting activities across the system. Plans and directs managed care operational practices including analyzing, negotiating and maintaining system wide Managed Care agreements. Monitors and updates Vice President on political, legal and regulatory trends with respect to managed care and vertical integration. Works with and oversees Medical Economics, Decision Support and Revenue Cycle operations to produce reports concerning managed care contract performance and operations. Plans and oversees education for Patient Financial Services (PFS) and applicable Revenue Cycle departments throughout the system in order to educate departments concerning contract terms, language and compliance. Facilitates resolution of contractual and operational issues with payers in order to enhance managed care contract performance. Contributes to the implementation of managed care vision and goals.
Qualifications
- Education: Bachelor's Degree from a recognized college or university in healthcare, managed care contracts, or related field; OR eight (8) years of experience in healthcare, managed care contracts, or related field.
- Work Experience: 5 years experience in Managed Care contract negotiations or related activities; OR 13 years of experience in healthcare, managed care contracts, or related field.
- Preferred: Hospital and payer experience.
Business Unit: Piedmont Healthcare Corporate