Facility: Various Locations
Department: MANAGED CARE CONTRACTING
Schedule: Full Time
Hours: M-F 8-5
Work among the best. We are a top 25 employer in the metro area offering a wide array of career opportunities within our organization. We have a leading reputation for patient care, medical education, research, and community service. We value and respect the talented, committed, and diverse people who make up our hospital; they are our most important strength. The hospital offers very competitive wages and an outstanding benefit package.
We currently have an opening for Managed Care Program Manager
Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
Demonstrates competence in the areas of critical thinking, interpersonal relationships, and technical skills.
Demonstrates ability to provide care/service safely and efficiently for the care of each patient/customer.
Serves as an effective communicator of the Health Systems vision and goals and the department's role in achieving those.
Analyze proposed contract reimbursement structure giving full thought and planning to the entire clinical enterprise for specialty network contracting.
Responsible for managing the contracting process for the Health System for specialty network contracts, including contract analysis, renewal and management with third party payers.
Recommend initial negotiations approach and methodology for contract renewals.
Serves as liaison with medical staff, clinic and hospital personnel with regard to third party payer issues .
Provides managed care consultation and education for UKHS staff.
Serves as the primary contact with payers regarding specialty contracting, develops and maintains strong relationship with appropriate personnel both with payers and internally. Leverages this relationship to anticipate needs of customers and potential changes with payers, communicating each appropriately.
Proactively manages contracts and payer relationships to ensure that UKHS is not excluded or disadvantaged as payers adapt or change their plans.
Acts on behalf of the Director of Managed Care when appropriate
Bachelor's Degree in Business Administration, Healthcare Administration or similar field required
Master's Degree in Business Administration, Healthcare Administration or similar field preferred
Experience and intermediate skills with Outlook, Word, and Excel required
Experience in a health care setting in the areas of hospital reimbursement and network management
*** If selected to move forward in the hiring process, you will receive an email invitation to schedule your interview for this position. Please continue to check your email after you have submitted your complete application online.
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